235: Patient Memories From the Intensive Care Unit Following Covid-19

Prentice, Donna; Taylor, Beth; Tymkew, Heidi; Rufkar, Britney; Archer, Jamie; Nellis, Patricia; Betthauser, Kevin; Lizza, Bryan; Wilson, Elizabeth M.; Smith, Sarah; Palmer, Christopher M.

doi:10.1097/01.ccm.0000807264.36533.cd

Cited by 2 publications

(8 citation statements)

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“… 31 Memory types most commonly described included memories of real events and emotions, with fewer reports of delusional memories. These results are consistent with the recent data thus far available from critical COVID-19 survivors 37 – 39 and are also in agreement with previous studies assessing the prevalence of post-discharge ICM memory types in non-COVID critically ill populations, although their frequency varies considerably in the literature. 25 – 27 , 31 …”

Section: Discussionsupporting

confidence: 93%

“…This was the most distinct finding arising from this study and is in line with earlier non-COVID ICM-memory studies 27 , 31 as well as recent available data from critical COVID-19 survivors, which have described a significant rate of recall of delusional memories in this population, with reported estimates ranging from 50% to 57%. 37 , 38 …”

Section: Discussionmentioning

confidence: 99%

“… 36 On the other hand, in the context of severe disease, 2 additional small-sized observational studies assessing ICM memory subtypes at 3 months post-infection suggested an elevated frequency of recall of delusional memories in this population of nearly 50% to 57%, which could influence long-term recovery. 37 , 38 Another recent study that included critical COVID-19 survivors indicated an association between the presence of depressive/anxiety symptoms and the recall of emotional and delusional memory categories. 39 Nevertheless, there is still a paucity of data on the full range of long-term post-ICM memories in critical COVID-19 survivors, and influence of deep sedation has not been fully defined.…”

Section: Introductionmentioning

confidence: 99%

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Influence of Deep Sedation in Intensive Care Medicine Memories of Critical COVID-19 Survivors

BRAGA

Martins

Ferreira

et al. 2023

J Intensive Care Med

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Introduction: Critical care survivors sustain a variety of sequelae after intensive care medicine (ICM) admission, and the Coronavirus Disease 2019 (COVID-19) pandemic has added further challenges. Specifically, ICM memories play a significant role, and delusional memories are associated with poor outcomes post-discharge including a delayed return to work and sleep problems. Deep sedation has been associated with a greater risk of perceiving delusional memories, bringing a move toward lighter sedation. However, there are limited reports on post-ICM memories in COVID-19, and influence of deep sedation has not been fully defined. Therefore, we aimed to evaluate ICM-memory recall in COVID-19 survivors and their relation with deep sedation. Materials/Methods: Adult COVID-19 ICM survivors admitted to a Portuguese University Hospital between October 2020 and April 2021 (second/third “waves”) were evaluated 1 to 2 months post-discharge using “ICU Memory Tool,” to assess real, emotional, and delusional memories. Results: The study included 132 patients (67% male; median age = 62 years, Acute Physiology and Chronic Health Evaluation [APACHE]-II = 15, Simplified Acute Physiology Score [SAPS]-II = 35, ICM stay = 9 days). Approximately 42% received deep sedation (median duration = 19 days). Most participants reported real (87%) and emotional (77%) recalls, with lesser delusional memories (36.4%). Deeply sedated patients reported significantly fewer real memories (78.6% vs 93.4%, P = .012) and increased delusional memories (60.7% vs 18.4%, P < .001), with no difference in emotional memories (75% vs 80.4%, P = .468). In multivariate analysis, deep sedation had a significant, independent association with delusional memories, increasing their likelihood by a factor of approximately 6 (OR = 6.274; 95% confidence interval = 1.165-33.773, P = .032), without influencing real ( P = .545) or emotional ( P = .133) memories. Conclusions: This study contributes to a better understanding of the potential adverse effects of deep sedation on ICM memories in critical COVID-19 survivors, indicating a significant, independent association with the incidence of delusional recalls. Although further studies are needed to support these findings, they suggest that strategies targeted to minimize sedation should be favored, aiming to improve long-term recovery.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influence of Deep Sedation in Intensive Care Medicine Memories of Critical COVID-19 Survivors

BRAGA

Martins

Ferreira

et al. 2023

J Intensive Care Med

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“…It is a fact that despite the efforts made towards early comfort using analgesia, minimal sedatives and maximal human care [ 12 ], having unpleasant and frightening memories of the intensive care stay is still predominant [ 13 , 25 ]. The SARS-CoV-2 pandemic has shown us that this is especially true for those patients requiring sedation and long-term mechanical ventilation [ 26 , 27 ]. From the patient’s perspective, evaluating the impact of these memories is important, as early stressful and frightening memories might contribute to long-term psychological morbidity after ICU [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…A potential limitation might be that the checklist was not tested in critically ill COVID-19 patients. However, recent research shows that these patients have a similar recall of stressful memories to that of the common ICU population [ 26 , 27 ]. Furthermore, ICU memory assessment is difficult to perform if the patient suffers from cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

The Stressful Memory Assessment Checklist for the Intensive Care Unit (SMAC-ICU): Development and Testing

Samuelson

2022

Healthcare

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Stressful or traumatic memories of an intensive care stay may lead to long-term psychological morbidity. Memory assessment is therefore essential to aid in the patients’ recovery process. Acknowledging the large cohort of post ICU patients during the SARS-CoV-2 pandemic, a simple tool for the evaluation of ICU memories is needed. The aim of this study was, therefore, to develop and test the validity and reliability of a short stressful memory assessment checklist, including a distress intensity rating scale, for intensive care survivors. The consecutive sample consisted of 309 patients attending an intensive care follow-up consultation in Sweden. A methodological design was used consisting of four phases. The first three concerned construct and content validity and resulted in a 15-item checklist of potential stressful memories with a Likert-type scale including five response categories for distress intensity rating. To fill out the checklist, a median of 3 (2–3) minutes was needed. A test–retest approach yielded weighted kappa values between 0.419 and 0.821 for 12 of the single items and just below 0.4 for the remaining three. In conclusion, the stressful memory assessment checklist seems to be valid and reliable and can be used as a simple tool to evaluate the impact of stressful ICU memories.

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235: Patient Memories From the Intensive Care Unit Following Covid-19

Cited by 2 publications

References 0 publications

Influence of Deep Sedation in Intensive Care Medicine Memories of Critical COVID-19 Survivors

Influence of Deep Sedation in Intensive Care Medicine Memories of Critical COVID-19 Survivors

The Stressful Memory Assessment Checklist for the Intensive Care Unit (SMAC-ICU): Development and Testing

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