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

• Published in: Journal of intensive care medicine 2023-07, Vol.38 (7), p.657-667
• Main Authors: Braga, A., Martins, S., Ferreira, A. R, Fernandes, J., Vieira, T., Fontes, L., Coimbra, I., Fernandes, L., Paiva, J. A
• Format: Article
• Language: English
• Subjects: Adult; Aftercare; COVID-19; Critical Care - psychology; Deep Sedation - psychology; Female; Humans; Intensive Care Units; Male; Middle Aged; Original Research; Patient Discharge; Survivors - psychology
• ISSN: 0885-0666; 1525-1489
• DOI: 10.1177/08850666231156782

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