A stay in an intensive care unit (ICU) as in case of life-threatening condition of acute respiratory distress syndrome, or ARDS may actually cause post-traumatic stress disorder (PTSD), according to a study conducted by researchers from Johns Hopkins University and published in the journal Psychological Medicine.
PTSD is an anxiety disorder characterized by three kinds of symptoms:
- Reliving trauma through nightmares or flashbacks;
- Physical or emotional avoidance (including through numbness and detachment) of reminders of the trauma; and
- Hyperarousal in response to such reminders (including irritability, difficulty sleeping and being easily startled).
The risks for psychiatric disorders are higher for women and young people, and for those who are unemployed or misuse alcohol prior to their ICU stay.
Understanding that patients will likely experience psychiatric symptoms after an ICU stay can help drive awareness and the development of improved mental health interventions
Use of an Intensive Care Psychological Assessment Tool (IPAT) – by nurses can be used to assess changes in the mental wellbeing of patients.
In three systematic reviews, ICU-based rehabilitation was associated with earlier achievement of mobility milestones and improved muscle strength including measures of respiratory, upper limb and/or lower limb strength. In one randomized controlled trial (RCT), supine cycle ergometry in mechanically ventilated patients was associated with improved physical function and quality of life
A range of methods including relaxation, breathing exercises and therapeutic approaches can help patients feel safe and more assured. Examples included eye masks for patients and softly playing music.
Ongoing evaluation and implementation of early rehabilitation programs for critically ill patients should be considered to address the common and long-lasting impairments associated with post-intensive care syndrome.