Intensivecare often involves treatment in a respirator, with the air being supplied either via a tube in the nose or mouth or via a cannula through the throat.To alleviate the discomfort of the treatment, patients are given sedatives or drugs to induce sleep.
In the past powerful sedatives were used, rendering the patient more or less unconscious. But this can lead to complications in the form of mucus accumulation, pneumonia, muscle atrophy, and prolonged respirator dependency.What's more such treatment is expensive. Therefore most wards have switched to lighter sedation, which is easier on the body.
However, the effects on the mental well-being of the patient have never been studied. This is what Karin Samuelson has now done in her doctoral dissertation, which she will defend September 22. She interviewed 250 patients five days after their release from the ICU and again two months later.
The results were hardly encouraging. Most of the patients had memories of their time in intensive care, despite the sedation, and more than half of them remembered at least one event that was extremely stressful. These stressful experiences included discomfort from the breathing tube and not being able to speak. One third of the patients also had delusional memories such as nightmares and hallucinations.
Two months after their discharge there was still a high degree of symptoms of anxiety in 5 percent of the patients, of depression in 8 percent, and of post-traumatic stress in 8 percent.
"The risk of remembering nightmares and hallucinations was more closely related to the length of the stay in intensive care than to the depth of sedation. On the other hand, the risk of remembering the experiences as bothering were associated with the depth of sedation: patients more awake experienced memories as more stressful. We must therefore focus on patients' subjective perceptions and get better at dealing with the psychological problems that critical illness and intensive care can lead to," says Karin Samuelson.
Among other things, this requires better following up of ICU patients. The Lund University Hospital staff has started to visit patients at the general wards a few days after ICU discharge and also to invite them back for a visit after two months. In this way it is hoped that they will be able to single out patients who have been the most seriously affected by their critical illness and their stay in the ICU and see to it that their experience there does not led to persistent mental disorders such as depression and post-traumatic stress.
Her dissertation is titled Sedation During Mechanical Ventilation in Intensive Care - sedation practices and patients' memory, stressful experiences and psychological distress.
Karin Samuelson can be reached at phone: +45 2680 1379 or e-mail: email@example.com
Ingela Björck | idw
One gene closer to regenerative therapy for muscular disorders
01.06.2017 | Cincinnati Children's Hospital Medical Center
The gut microbiota plays a key role in treatment with classic diabetes medication
01.06.2017 | University of Gothenburg
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...
19.06.2017 | Event News
13.06.2017 | Event News
13.06.2017 | Event News
23.06.2017 | Physics and Astronomy
23.06.2017 | Physics and Astronomy
23.06.2017 | Information Technology