NCPA - National Center for Policy Analysis


January 14, 2009

While patients may be suffering lingering effects from illnesses that landed them in the intensive care unit (I.C.U.), researchers are increasingly convinced that spending days, weeks or months on life support in the units can elicit unexpected, long-lasting effects.  In response, some I.C.U.'s are trying what seems like a radical solution: reducing sedation levels and getting patients up and walking even though they are gravely ill, complete with feeding tubes, intravenous lines and tethers to ventilators.

According to a recent study, even a few days in an I.C.U. can be physically devastating immediately afterward:

  • Nearly 25 percent of patients who have spent at least 5 days on ventilators could not use their arms to raise themselves to sitting positions; many could not push back against the researcher's hand.
  • Most patients who spend time in an I.C.U. lose significant weight.
  • Some have difficulty thinking and concentrating or have post-traumatic stress disorder and terrible memories of nightmares they had while heavily sedated.

Researchers say the questions about how and why an I.C.U. stay can be so devastating -- and new efforts to bring a marked change to the experience -- are of increasing importance because, as the population ages, more people are being admitted to the units.  And with medical advances, more patients are surviving, says the Times.

In a pilot study, doctors found that patients seem to recover faster, spending less time in intensive care and the hospital.   However, it remains difficult to tease out which disabilities come from the illness as opposed to the I.C.U. stay.   Nevertheless, doctors are beginning to worry about the effects of simply being in an intensive care unit as it looks like what was lost may not completely come back.

Source: Gina Kolata, "A Tactic to Cut I.C.U. Trauma: Get Patients Up," New York Times, January 12, 2009.

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