Nancy
Kentish-Barnes, Philonille
Degos, Clémence Viau, Frédéric Pochard & Elie Azoulay
Intensive Care Medicine Published: 11
May 2021
During the initial pandemic of coronavirus disease 2019
(COVID-19), visits in the intensive care unit (ICU) were either banned or
highly restricted. Consequently, family members and patients were often
separated from each other. Quantitative and qualitative research has shown that
this restriction was an extremely difficult and even harmful experience for
both family members and ICU clinicians [1, 2].
Lack of visits is a well-known risk factor for delirium [3]
and studies have shown that extending visiting policies can strongly reduce
both the incidence of delirium and its length [4].
In this qualitative pilot study that included semi-structured interviews with
12 ICU survivors of the COVID-19 9–10 months after their discharge, we sought
to better understand the experience of patients’ hospitalization in the ICU
during the first wave of the pandemic (Supplemental material). Qualitative
analysis provides an in-depth insight into the relationship between the patient
and his loved-one in the ICU, although our data may not precisely translate how
patients actually felt in the moment, given a potential for recall bias and the
effect of media exposure between the ICU stay and the interviews.
Most patients (9/12) reported having no memories of their
ICU admission: their first memory was gaining consciousness after their coma
(due to sedation for mechanical ventilation). Patients described being agitated
and confused, not knowing whether their dreams were reality or not (Table 1,
Q1). Many patients described terrifying dreams during which they thought they
were going to die (Table 1,
Q2). ICU delirium is well described and can cause patients to have horrifying,
violent hallucinations to the point where they feel that they are going crazy.
In our study, patients described not knowing where they were and having no familiar
faces to reassure them (Table 1,
Q3).
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