Recovering from Intensive Care (ICU)

If you have spent time in Intensive Care (ICU) then it means that you have had a serious and life threatening illness.  Time in the ICU can be challenging to cope with; an unfamiliar place with lots of strange sights, smells, noises and sensations; a time where things might be confusing, scary and unclear in your mind.  As well as coping with the physical recovery from these illnesses / injuries there is also the emotional and psychological recovery.

Information for Patients who have recently had a stay in Intensive Care

After a stay in the intensive care unit (ICU) and a period of severe illness some patients can experience a collection of symptoms commonly known as Post Intensive Care Syndrome or ‘PICS’ for short. You may have noticed some signs and symptoms of this. If so don’t worry, it is very common.

Common symptoms of PICS that many patients experience are:

ICU acquired physical weakness – Having a prolonged stay in hospital or ICU can affect muscles and nerves throughout the body leading to marked muscle wasting, nerve (neuropathic) pain and feelings of numbness (paresthesia) in some areas of the body.

Patients often experience problems with:

  • Balance and coordination
  • Difficulty mobilising, e.g. transferring to a chair, or bending down to pick something up
  • Difficulty eating, holding a cup, working a TV control, putting on glasses etc.

Delirium – This is very common and occurs in about 80% of ICU patients. It occurs in ALL ages. If you were on a breathing machine whilst in ICU you are more likely to have developed Delirium.

Delirium is caused by changes in the way the brain works. These changes in the brain can be caused by the critical illness, or infection itself and medicines used in ICU such as sedatives and pain killers.

Some of the signs and symptoms of Delirium that you or your family member/ caregiver might have noticed while you were in ICU are:

  • Appearing agitated
  • Confusion
  • Aggression
  • Using inappropriate words
  • Inability to pay attention or follow directions
  • Confusion about where you are, or the time of day
  • Seeing or hearing bizarre or unusual things that are not there
  • Acting different from usual

Nursing staff see these symptoms in ICU all the time and are used to dealing with them when they occur. Delirium usually resolves after you leave ICU. But, patients often have problems afterward which can take a while to subside.

These longer lasting problems include:

  • Problems with concentration and memory – Memory is a complex brain activity and takes time to recover when you have been unwell. This means following your ICU stay you might have to have things repeated to you several times, or you may find you forget what has been said to you easily. You may also find it difficult to concentrate on something for any length of time. 
  • Anxiety, depression; sleep disturbance; and/or nightmares and flashbacks – These symptoms are common and very normal after being in ICU. Remember that you have just been through a really traumatic experience which is going to take while to get over. In most cases these more psychological symptoms will gradually subside. But for some patients they can persist. If they do persist seek help from your GP who can refer you to an appropriate service for support and treatment.
  • Reduced appetite – Following an ICU stay some patients also commonly report feeling less hungry. Changes in sense of smell and taste are common after ICU and contribute to this. After a stay in ICU with a severe illness, many people find they need to eat little and often and many struggle with eating the standard ‘3 square meals’ a day. If you do really struggle with your appetite after ICU stay speak to your GP about this.

Created by Dr Jackie Fearn

Consultant Clinical Psychologist NHS Fife

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