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If you want to know how long it takes for your mother to wake up after a ruptured aneurysm in intensive care on a ventilator, stay tuned! I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com and today I have an email from Ruth who says, “Hi, Patrik. My mother has a ruptured aneurysm surgery, it has been one week. She’s in ICU with ventilation support and she had a tracheostomy as well. She’s not opening her eyes, but nurses say she’s slightly opening her mouth and moving sometimes. She’s only 58. Does it take a lot of time for her to wake up and talk?”

Well, thank you, Ruth for your email and thank you for your great question.

I have seen many, many patients in ICU with ruptured aneurysms and I’ve looked after many of them. Because I have worked in critical care nursing for 25 years in three different countries where I also work as a nurse unit manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives for our clients in intensive care. You can verify that by looking at our testimonial section at intensivecarehotline.com. You can verify that by looking at our intensivecarehotline.com podcast section where we have also done some client interviews.

So coming back to your question Ruth, when someone goes into intensive care with a ruptured aneurysm after surgery, but it is absolutely life-saving surgery because it is a life-threatening situation. When an aneurysm bursts, there’s not much time to rush someone into the operating room, depends a little bit on where the aneurysm is. But if it’s located at one of the major arteries like the aorta, the abdominal aorta or the ascending aorta, it is absolutely life-threatening and there’s not much time to waste and patients need to be rushed to the operating room as quickly as possible. Then, there’s no guarantee that a patient will survive this particular type of surgery, but your mom did and that is really, really positive.

Now, what happens during surgery is often that patients end up with a lot of blood loss and they need multiple blood transfusions going from getting red blood cells, FFPs (Fresh Frozen Plasma), platelets, and multiple of them and that can save their life. They also often end up on vasopressors and inotropes to maintain a blood pressure that is compatible with life because the blood loss during this type of surgery can be very significant.

What happens during surgeries? The surgeons might cut out the aneurysm and then might put the pieces together again or they might put a stent in there to patch the area where the aneurysm is located. One way or another, this surgery is often time-consuming. It is life-saving, but it is also very life-threatening when you have a burst aneurysm in one of your major arteries.

Now, when someone then goes back into intensive care, it often takes days, I have seen sometimes even weeks to stabilize the patient because it is such big surgery. Once again, patients end up having multiple blood transfusions, ranging from red blood cells, FFPs, and platelet transfusions. They also often end up on multiple inotropes or vasopressors to, once again, maintain a blood pressure that is compatible with life and maintain a blood pressure that maintains kidney perfusion.

Now, one thing that you haven’t said here is that you mom has gone into kidney failure . A lot of patients after an aortic aneurysm repair go into kidney failure and need at least temporary dialysis or hemofiltration. So, one of the questions you should be asking actually is if the kidneys are working.

Now, you are saying your mom has been having a tracheostomy also, that’s only after a week in the ICU now. That is a little bit strange because a tracheostomy should be done after about Day 10 to Day 14 in the inability to wean a critically ill patient off the ventilator. After 7 days, I argue, it’s a little bit too early to do a tracheostomy or within that seven-day period, but obviously, that is what has happened in your mom’s situation.

You’re also saying she’s not opening her eyes, but the nurses say she’s slightly opening her mouth and moving some time. If your mom has a tracheostomy, she should be off all sedation and she should be off all or most opiates. The aneurysm repair usually requires abdominal surgery and that can be quite painful. So maybe, she still needs some opiates for pain control. She should be off all sedatives so that she can actually wake up.

What is also important to ask here is if your mom potentially sustains some form of brain injury .   Is that why she’s not waking up?  Well, what can happen, once again, during aneurysm repair, there’s a high risk that your mom might have had a cardiac arrest or being close to a cardiac arrest. Ask them whether she had potentially a cardiac arrest or her heart stopped during the surgery. Did they ended up doing CPR (Cardiopulmonary Resuscitation)? I do believe that is a relevant question in a situation like that.

If they ended up doing CPR, for example, would there be some brain damage? Is that the reason for her not waking up? Also, has she been hemodynamically so unstable after the aneurysm repair surgery that she needed lots of sedation, lots of opiates, and potentially needed to be paralyzed, even chemically paralyzed? That is with medications. Is that causing a delay in her waking up?

So, at this particular point in time, you need to be patient. Also, you’re asking when will she wake up  and talk? Once again, she needs to be off all sedatives and opiates. With the talking, if she has a tracheostomy, the first thing that needs to happen is she needs to come off the ventilator. Only then can she be weaned off the tracheostomy , only then could they start using a speaking valve, and only then can she start to talk again.

So, she’s probably far removed from talking at the moment. She needs to be stabilized first. The kidneys need to work. All other organs need to work. She needs to wean off that ventilator. She probably needs to wean off inotropes and vasopressors. It’s going to be a long road to recovery probably, but you should be very grateful that your mom is still around and survived this type of surgery. Hopefully, she can get out of it step by step. Other things they should be focusing on is giving her physical therapy or physiotherapy. Starting to move her arms and legs and once she is more stable, also get her out of bed. The sooner, the better. The sooner she will recover, but it has to be step by step. It is major surgery.

I hope that answers your questions, Ruth.

We have helped hundreds of members and clients over the years here at intensivecarehotline.com to improve their lives instantly when they have a loved one critically ill in intensive care. Like I said, we have saved many lives as part of our consulting and advocacy. That’s why we created membership for families of critically ill patients in intensive care. You can become a member by going to intensivecarehotline.com, by clicking on the membership link or if you go to intensivecaresupport.org  directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I’ve personally written and recorded. All of those resources will help you to make informed decisions, have peace of mind, control, power, and influence so that your loved one gets best care and treatment always.

I also do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I talk to doctors and nurses directly as well. When I talk to doctors and nurses directly, I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care. I will hold them accountable. I also represent you in family meetings with intensive care teams. I basically handhold you through this once in a lifetime situation that you simply can’t afford to get wrong.

We also do medical record reviews in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to support@intensivecarehotline.com with your questions.

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Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

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