Prolonged acute care in a 52-year-old man with respiratory failure: Lessons learned from 70-day intensive care unit hospitalization

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Purpose:This study was undertaken to record the experiences of a patient who survived prolonged intensive care unit (ICU) care secondary to acute respiratory failure.Materials and Methods:The patient's medical record was summarized, and the patient was interviewed with audio recording and transcription. He completed several surveys, including the ICU memory tool, the 14-question Posttraumatic Stress Syndrome Questionnaire, the Impact of Event Scale-Revised Questionnaire, and the Hospital Anxiety and Depression Scale Questionnaire.Results:The patient had little factual recall of his prolonged ICU care but had multiple delusional memories from this period. The Impact of Event Scale-Revised results indicate that this hospitalization had significant impact. However, his scores on the 14-question Posttraumatic Stress Syndrome and Hospital Anxiety and Depression Scale questionnaires indicate that his risk for posttraumatic stress disorder, anxiety, and depression is low. These outcomes were attributed, in part, to his willingness to discuss his ICU care and experiences with health care workers, family, and friends.Conclusions:Patient debriefing may improve outcomes after prolonged acute care. Current survey instruments provide a good estimate of a patient's mental status. Patients themselves can provide important information about hospital care and areas needing improvement.

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