Intensive care patients ‘could suffer PTSD’ and need physical and psychological help afterwards

Zoe Tidman
Doctors and nurses on an intensive care unit (ICU) in University College Hospital: BBC

Intensive care patients could require physical and psychological help — including for post traumatic stress disorder (PTSD) — after the experience, according to a leading doctor.

Carl Waldmann told The Independent people who have been critically ill may need to have support after their stay in the Intensive Care Unit (ICU) as they return back to normal life.

“They may need physical rehabilitation as they are so weak, you lose muscle mass very easily, and also need psychological support,” the board member of the Faculty of Intensive Care Medicine said.

“Some patients have had nightmares and weird dreams — part of PTSD. As Covid-19 is a new disease, it is too early to say if there will be similar outcomes for these patients.”

In a paper in medical journal The Lancet, Talha Khan Burki said a stay in ICU “can be traumatic” for a host of reasons, including being faced with your own mortality, difficulty communicating and potentially seeing death around you.

“Available data suggest that roughly a quarter of patients who survive admission to the ICU meet the diagnostic criteria for PTSD,” the author wrote, “while a much higher proportion exhibit symptoms of the disorder.”

After the first follow-up clinics for intensive care patients were set up in the UK in the 1990s, clinicians noticed many people struggled to get back to work as they tried to recover their physical strength and battled with psychological problems including PTSD, Dr Waldmann said.

The Faculty of Intensive Care Medicine is working to ensure physical rehabilitation and psychological support for discharged patients — already available at some hospitals — becomes an integral part of intensive care facilities around the country.

The need for this aftercare service may increase “several fold” as a result of the coronavirus pandemic due to an increased number of ICU patients, Dr Waldmann said.

The NHS has been preparing for a surge in intensive care patients during the UK’s outbreak. The Nightingale hospital opening its doors in London earlier this week, containing up to 4,000 beds for those who require further intensive care treatment for Covid-19.

More than 60,000 people have tested positive for coronavirus — a flu-like disease that can turn into pneumonia — in the UK as of Wednesday, according to government figures.

When asked how long it could take hospitalised coronavirus patients to return to work, Dr Waldmann of the Faculty of Intensive Care Medicine told The Independent it was too soon to be able to tell.

“No one knows,” he said. “No one has really had the time to look at the impact afterwards.”

Anthony Gordon, chair in anaesthesia and critical care at Imperial College London, told the Today programme on Wednesday recovery can be a “gradual process” for patients.

“Individual people recover at different time frames,” he said on Wednesday. “I think when you are seriously ill it does take time to recover.”

“It can take certainly many weeks to get back to your normal full health or even months to full physical capacity,” he said. ”But people recover gradually over time and we advise people to have graded returns to work for instance.”

The number of confirmed cases rose by more than 5,400 to reach 60,733 on Wednesday, while the death toll stood at 7,097, according to the Department of Health and Social Care.

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