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For many patients, life after intensive care includes trauma, nightmares

One intensive care unit patient recalled seeing waves of the open ocean and sensing that someone was underneath her bed at Baylor University Medical Center at Dallas.

Another patient, who was treated at a Fort Worth hospital, said she saw helicopters evacuating patients as a tornado approached.

For the two women, the memories were painful and vivid despite the fact that none of those things actually happened. They both appear to have suffered from post-intensive care syndrome (PICS), which is “made up of health problems that remain after critical illness,” according to the Society of Critical Care Medicine.

“They are present when the patient is in the ICU and may persist after the patient returns home,” according to the organization. “These problems can involve the patient’s body, thoughts, feelings, or mind and may affect the family. PICS may show up as an easily noticed drawn-out muscle weakness, known as ICU-acquired weakness; as problems with thinking and judgment, called cognitive (brain) dysfunction; and as other mental health problems.”

The Baylor Dallas patient, Celina Montes, who suffered severe injuries in an April 2013 car accident, recently told of her experience with PICS in an interview with WFAA-TV (Channel 8).

“I knew I could see the waves,” Montes said in the interview. “I thought there was somebody underneath my bed, because they were reaching for my feet. And they were trying to keep me here … It was very frightening.”

A 2013 piece in The New York Times about ICU-induced post-traumatic stress disorder said: “Annually, about five million patients stay in an intensive care unit in the United States,” according to The Times report. “Studies show that up to 35 percent may have symptoms of PTSD for as long as two years after that experience, particularly if they had a prolonged stay due to a critical illness with severe infection or respiratory failure. Those persistent symptomsinclude intrusive thoughts, avoidant behaviors, mood swings, emotional numbness and reckless behavior.”

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Yet, as The Times noted, “I.C.U.-induced PTSD has been largely unidentified and untreated.”

PICS is being studied here by Ann Marie Warren, Ph.D., a clinical psychologist on the staff at Baylor Dallas. She told WFAA that sedation and changes in the sleep-wake cycle can trigger the bizarre hallucinations.

Patients who suffer from any of the symptoms associated with PICS should know that it is treatable and that they should see their doctor, Warren said.

One way for relatives and caregivers to help is to keep a diary of the patient’s ICU stay in order to provide them with an accurate accounting later.

Warren’s examination of PICS is part of a broader study of outcomes following injuries, including those that lead to an ICU stay. The study is also looking at the impact of having a loved one in the ICU.

About the author

Scott Goldstein
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Scott is a former Dallas newspaper reporter. His father and two brothers are doctors, so healthcare is his family business.

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For many patients, life after intensive care includes trauma, nightmares