Sedation and memories in critical care - Critical Care Science (CCS)
Sedation strategies in intensive care units (ICU) have changed over the past decade towards daily wake-up calls, less sedation and even no sedation.(–) Furthermore, new ventilatory modes were designed to promote better patient synchrony with the ventilator and fewer sedation requirements. It is well known that the strategies used to reduce sedation reduce the length of mechanical ventilation and hospital stay.(–) However, there is increasing concern about which is the best sedation strategy regarding memory recall and post-traumatic stress disorder (PTSD) after ICU discharge.()
There is growing evidence of poor mental health and quality of life among survivors of intensive care. Many studies have evaluated patients’ ICU memories at varying periods after ICU discharge with conflicting results. Some studies have described little or no memory for real events during their ICU stay(,) or only the remembrance of pain, suctioning, or lack of sleep.() Others have described memories of vivid nightmares, hallucinations, and paranoid delusions.(,) These experiences are often very frightening, which may predispose patients to form vivid and durable memories. Studies suggest that even relatively unpleasant memories of real events (factual recalls) during a critical illness may provide some protection from anxiety and the later development of PTSD-related symptoms compared with prominent delusional memories.()
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Sedation strategies in intensive care units (ICU) have changed over the past decade towards daily wake-up calls, less sedation and even no sedation.(-) Furthermore, new ventilatory modes were designed to promote better patient synchrony with the ventilator and fewer sedation requirements. It is well known that the strategies used to reduce sedation reduce the length of mechanical ventilation and hospital stay.(-) However, there is increasing concern about which is the best sedation strategy regarding memory recall and post-traumatic stress disorder (PTSD) after ICU discharge.()
There is growing evidence of poor mental health and quality of life among survivors of intensive care. Many studies have evaluated patients' ICU memories at varying periods after ICU discharge with conflicting results. Some studies have described little or no memory for real events during their ICU stay(,) or only the remembrance of pain, suctioning, or lack of sleep.() Others have described memories of vivid nightmares, hallucinations, and paranoid delusions.(,) These experiences are often very frightening, which may predispose patients to form vivid and durable memories. Studies suggest that even relatively unpleasant memories of real events (factual recalls) during a critical illness may provide some protection from anxiety and the later development of PTSD-related symptoms compared with prominent delusional memories.()
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