ICU DOCTORS TRYING SOMETHING NEW
The New York Times reports that ICU doctors are trying a new tactic to reduce the trauma that patients face after a stay in the ICU: reducing sedation levels and getting patients up and walking.
Researchers have found that patients who spend days, weeks, or months in the ICU on life support can suffer from unexpected and long-lasting effects, such as difficulty concentrating, nightmares, or even post-traumatic stress disorder. The study, sponsored by Ohio State University, reported that 25 percent of patients who spent more than five days on ventilators could not use their arms to raise themselves to sitting positions; many could not push back against a researcher's hand. One researcher described the patients as "essentially paralyzed."
Studies about the after-effects of stays in the ICU are more important than ever these days, given the aging population and the advances in medicine -- as more people age, more people are admitted to the ICU, and with the medical advances, more people are surviving.
Most patients who spend time in the ICU lose significant weight and quickly lose their strength. Researchers are becoming concerned about the effects of being in the ICU hooked up to a ventilator that forces oxygen in and out of the lungs and receiving doses of sedatives, narcotics and anesthetics high enough to make even healthy people stop breathing on their own. Dr. John Kress, director of the medical ICU at the University of Chicago decided to experiment by waking patients briefly each day by turning off their infusion of sedatives. He found that patients did better and had a significantly lower rate of post-traumatic stress disorder. He could not be sure why there was less post-traumatic stress, but opined that maintaining awareness of reality is better for the patient's psyche. In another study sponsored by Brigham Young University, researchers found that patients seemed to recover faster and spent less time in intensive care and the hospital.
Researchers plan to do a number of clinical trials to improve ICU stays, and the after-effects of those stays, for patients in the future.
