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Materials and Methods: After receiving ethical committee approval, all the patients who stayed ≥24 hrs in our ICU within 6 months were included. Patients with dementia, psychiatric disease were excluded. The overall rating of the sedation and patient ability to tolerate the ICU setting was recorded (between 1-5) every shift by the nurses and the physicians. 32 item questionnaire was used to collect data about patients' stressful ICU experiences by interviews after discharge from the ICU (1).
Results and Discussions: 35 patients were interviewed. 4 (11%) patients did not remember being in an ICU. The mean ± SD of the age of the patients was 37 ± 22 yrs, the weight was 60 ± 17 kg and the SAPS II score on admission was 34.5 ± 19. 23 (66%) patients were female. The duration of ICU stay and mechanical ventilation were 4 ± 3 days and 1286 ± 767 hrs, respectively. The items that were bothersome include not being able to speak (88% of the patients who remembered the experience), discomfort due to endotracheal tube (ETT) (74%), feeling choked by ETT (80%), ETT interference with sleep (82%), not getting enough air from the ETT (68%), being thirsty (75%), difficulty swallowing (69%), noise (74%), pain (80%), feeling something bad will happen (100%), tense (71%), depressed (78%), fearful (89%), nervous (81%), missing loved ones (88%), nightmares (87.5%), headaches (90%). The patients who had adequate sedation (average rating ≥ 4) were bothered less by remembering choked by ETT (median score (95%CI) of the item, 1(0-5)) not getting enough air from the ETT (0(0-4.6)), difficulty swallowing (2(0-5)), and being restrained (0(0-4)) compared to the patients with inadequate sedation (medians of the items, 4(0-5), 3.5(0-5), 4(0-4), 2.5(0-5) respectively) (p < 0.05).
Conclusion(s): Patients in the ICU remember numerous stressful experiences. Adequate sedation decreases some of the physical symptoms. More improvements are needed to further decrease the stressful experiences in the ICU.
