Every year, 80,000 seriously ill patients are admitted to the intensive care unit (IC). Now with the corona outbreak, there are even more. It is estimated that half of these people will develop serious complaints after an IC admission. Three questions about the post intensive care syndrome (pics).
What happens on an IC?
A patient ends up in the intensive care unit when vital bodily functions are compromised. These are, for example, breathing, blood circulation or kidney function. These functions are monitored with high-tech equipment and medicines and taken over if necessary.
An IC recording is often necessary after major surgery, for example on the heart or brain. But IC admission can also be unexpectedly necessary, for example after an accident or in the event of a serious infection, such as with the coronavirus.
A team of intensivists, ICU nurses, ICU doctors and physiotherapists is available day and night to provide care. When the acute danger has passed, the patient can go to a ward with high or medium care, or to the nursing ward and finally back home. But then the rehabilitation actually starts and it doesn’t always go well.
Why do many people die in the year after an IC admission?
Figures from 2015 show that 91% of patients leave the ICU alive. (The figures about corona patients are not yet available) What not everyone knows is that relatively many people still die after an IC admission. After one year, 77% of people are still alive. It is estimated that half of the people suffer from serious complaints after an IC admission. So the first year after an IC is tough.
Doctors and scientists do not yet know exactly what the numbers are and why. They do see that half of the patients who are in the ICU for two days or longer no longer return to the old level. This can mean no longer working, or no longer living independently at home.
And how is it, for example, 5 years after IC treatment? We don’t know that yet. At the Radboudumc there is in any case research done.
Research into the consequences of an IC admission is still a ‘young’ field. The post-intensive care syndrome was not documented by doctors in America until 2012. So it has only just been discovered. Doctors therefore do not always recognize the post-ic symptoms. They don’t make the connection with an IC recording from months ago. However, there are more and more hospitals that provide extra care to patients who are getting rid of an IC, in the hope that it will reduce the complaints. For example, the Catharina hospital in Eindhoven has developed a diary, which can help in the period after the IC admission.
What complaints are those?
Fatigue
Many people are intensely tired after being admitted to the intensive care unit. This has all kinds of causes, such as the disease itself, muscle weakness due to lying down for a long time or breaking the day-night rhythm. Delirium is also common, especially if you are older, and that is also intensely tiring.
Thought problems and psychological complaints
You may also have problems with thinking, such as confusion, memory problems or concentration problems. Psychological complaints such as anxiety or depression or post-traumatic stress disorder also occur.
flabby muscles
The muscles deteriorate rapidly during an IC recording, especially with a ventilator. People can really lose pounds of muscle mass. Movement is therefore very important in the rehabilitation after an IC admission. That is not so easy, because the tendons, muscles and joint capsule can be out of shape. Physiotherapy can help with that.
shortness of breath
With ventilation you no longer use your own breathing muscles. So they have to get back to work when the ventilation stops, and that is difficult. Many people are therefore short of breath after an IC recording.
Mouth and throat problems
Because of the tube feeding and the medicines, smell and taste can also be changed after an IC recording. The tube in your throat can also cause difficulty in swallowing and sometimes speaking if the vocal cords are damaged. You may sound hoarse or get a weaker voice.
There are even more complaints, which can be found on this IC Connect website, founded by ex-IC patients and family members. An IC recording is also very drastic for the family. They can also get complaints. That’s called PICS family.
Sources: IC Connect, Volkskrant, Radboudumc, Medical Contact
