ICU syndrome is a disorder often afflicting intensive care unit (ICU) patients, who experience a cluster of serious psychiatric symptoms after an acute illness or traumatic event. The syndrome is also a form of delirium, or acute brain failure, and can be referred to as ICU psychosis. While ICU syndrome may last anywhere from 24 hours to two weeks, it is treatable.

What Are the Symptoms of ICU Syndrome?

 The onset of ICU syndrome can happen rapidly and results from a myriad of factors colliding as a patient is stabilizing and recovering. Because the ICU is typically a foreign environment to patients, everything from the lighting and smell, to the lack of familiar human interaction, can result in an array of psychiatric symptoms including:

• extreme excitement and anxiety
• restlessness, agitation and disorientation
• hearing voices and hallucinations
• clouding of consciousness and fluctuating aggressive or passive behavior
• nightmares, paranoia and delusions

Simply put, patients become temporarily psychotic. With each patient, the list of symptoms can widely vary, and the onset can be scary and upsetting to the patient and family members witnessing the situation.

What Causes ICU Syndrome?

Research shows there are two causal areas for ICU syndrome: environmental and medical.

Environmental Causes

• Sensory deprivation and overload: The unfamiliar setting, artificial light with possible lack of windows, abnormal sounds on the hospital floor, noisy monitoring devices and being away from loved ones who typically provide comfort
• Sleep disturbance and monitoring: The necessary, yet constant, disturbance and noise of the hospital staff checking patients’ vitals, administering medications and doing rounds
• Continuous light levels: The continual presence of light disrupts patients’ biorhythms and can cause confusion about day versus night and awareness of time and date
• Stress: A feeling of near total loss of control elevates already-high stress levels

 Medical Causes

• Pain: Pain might not be adequately controlled in an ICU
• Critical illness: Stress on the body’s functions as a result from the actual illness, disease or trauma itself
• Drug reaction or side effects: Medications typically given to a patient in the hospital have likely not been taken before
• Metabolic disturbances: The body’s systems are disrupted, including electrolyte imbalance, hypoxia (low blood oxygen levels) and elevated liver enzymes
• Heart failure: Inadequate cardiac output and function
• Dehydration: Medications, some treatments and impaired ability to self-monitor can leave a patient without adequate hydration

How to Manage ICU Syndrome

Seasoned nurses with expertise in treating severe trauma in the ICU are the first line of defense by working diligently to ensure the best possible patient care. These professionals play the critical role of observing behavior and communicating the right information at the right times to minimize risk.

Both patients and families need to feel confident in the care they are receiving and trust their provider team. Everything from prescribing early mobility to altering visiting hours can have an effect on treating ICU syndrome effectively and planning for a successful patient discharge. Patients typically make a full mental and physical recovery.

If ICU syndrome occurs to an injured person supported by Paradigm Outcomes, the care management team would ensure a proper diagnosis and work closely with the treating physicians to chart an evidence-based course of treatment that addresses all the condition’s complexities. Our network managers would provide onsite monitoring and support the patient and her family with both sound judgment and extreme sensitivity.

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