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Hospitals struggle to address terrifying and long-lasting ‘ICU delirium’

When his fever spiked, he thought someone was setting him on fire. When orderlies slid him into an MRI, he thought he was being fed into an oven. Frequent catheter changes seemed like sexual abuse. Dialysis? He thought someone was taking blood out of a dead woman’s body and injecting it into his veins.

The horrifying, violent hallucinations plagued David Jones, now 39, during a six-week stay in the intensive care unit at Chicago’s Northwestern Memorial Hospital — and for months after he was discharged. He thought he was going crazy and felt very alone.

He wasn’t.

Recognizing the prevalence of the problem, doctors and nurses across the country are now pushing an ambitious…

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Featured

 ‘ICU Delirium’ Is Leaving COVID-19 Patients Scared and Confused

The mental toll of intensive care can be more severe than the physical one.

 ‘They Want to Kill Me’: Many Covid Patients Have Terrifying Delirium

Paranoid hallucinations plague many coronavirus patients in I.C.U.s, an experience that can slow recovery and increase risk of depression and cognitive issues.

Previously Featured

How To Prevent Brain-Sapping Delirium In The ICU

If you are one of the 5.7 million Americans who ends up in the intensive care unit each year, you are at high risk of developing long-term mental effects like dementia and confusion. These mental problems can be as pronounced as those experienced by people with Alzheimer's disease or a traumatic brain injury and many patients never fully recover.

Antipsychotics not helpful for delirium in ICU

“This is strong evidence from what we consider a ‘gold standard’ clinical trial showing that these two antipsychotics don’t work to treat delirium during a critical illness,” says NIA Deputy Director Dr. Marie A. Bernard. “Antipsychotics have often been used to treat delirium. The evidence from this study suggests the need to reexamine that practice.”

Intensive Care Unit Syndrome A Dangerous Misnomer

We conclude that ICU syndrome does not differ from delirium and that ICU syndrome is caused exclusively by organic stressors on the central nervous system. We argue further that the term ICU syndrome is dangerous because it impedes standardized communication and research and may reduce the vigilance necessary to promptly investigate and reverse the medical cause of the delirium. Directions for future research are suggested.

Nightmares After the I.C.U.

The I.C.U. setting itself can feel sinister to patients, as if lifted from “The Twilight Zone.” The eerie, sleep-indifferent lights. The cacophony of machines and alarms.

Raising an alarm, doctors fight to yank hospital ICUs into the modern era

The first thing you notice are the alarms. Walk into the intensive care unit in just about any American hospital, and you’ll be bombarded with beeping and blaring noises and flashing lights. It may look high tech. It’s not.

The Overlooked Danger of Delirium in Hospitals

The condition, once known as “ICU psychosis,” disproportionately affects seniors and those who have been heavily sedated—and the delusions can last long after they’re discharged.

When a Stay in Intensive Care Unhinges the Mind

Perhaps it is sensory deprivation -- being caged in a windowless room, away from family and familiar things. Or perhaps the sensory overload -- being tethered to noisy machines that are on all day and night. It could even be something as banal as pain, which studies show is often inadequately controlled in the ICU.

When ICU Delirium Leads To Symptoms Of Dementia After Discharge

Doctors have gradually come to realize that people who survive a serious brush with death in the intensive care unit are likely to develop potentially serious problems with their memory and thinking processes.

Resources

ICUDelirium.org

The 'classic' care of critically ill patients is similar to a 'dementia factory.' It is up to us to close this factory. Dr. Raúl Alejandro Gómez, Intensivist Physician, Buenos Aires

Canadian Family Physician

Patients who become psychotic in intensive care units are usually suffering from delirium. Underlying causes of delirium such as anxiety, sleep deprivation, sensory deprivation and overload, immobilization, an unfamiliar environment and pain, are often preventable or correctable. Early detection, investigation and treatment may prevent significant mortality and morbidity.

MedicineNet

ICU psychosis is a disorder in which patients in an intensive care unit (ICU) or a similar setting experience a cluster of serious psychiatric symptoms. Another term that may be used interchangeably for ICU psychosis is ICU syndrome. ICU psychosis is also a form of delirium, or acute brain failure.