Quick Tip for Families in ICU: Pneumonia in ICU After Liver Failure!

Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care. So, today I want to talk about another situation of two steps forward, one step back, and what do I mean by that?

So, we have a client currently in ICU after cardiac arrest with liver failure. Initially, kidney failure as well, severe GI (Gastrointestinal) bleeding, needed multiple transfusions, developed several thrombosis despite needing heparin, which is an anti-coagulant. So many challenges this patient faced.

He actually pulled through and eventually stopped bleeding. They were able to stop the heparin. They were able to do a tracheostomy after about three weeks in ICU. And things were looking like they were slowly improving and then all of a sudden he developed the pneumonia. And that was despite him having some spontaneous breathing trials, he did really well on that. And then a big setback came, his respiratory function deteriorated. He ended up with pneumonia. They had to change him from spontaneous breathing back to controlled, to SIMV (Synchronized Intermittent Mandatory Ventilation) mode with high FiO2s (Fraction Of Inspired Oxygen), high PEEP (Positive End-Expiratory Pressure), high pressure support.

And this is another sign of patients in ICU going two steps forward, one step back. The longer someone is on a ventilator, the more likely they develop a pneumonia, also known in ICU as a “ventilator-associated pneumonia.” Again, the longer someone is in ICU, the higher risk that a ventilator-associated pneumonia is developing.

Now, what’s next for our client? Next is probably he needs to be started on antibiotics again. He needs to have cultures done, sputum culture, urine culture, and blood cultures to make sure they can identify the infection and treat it accordingly. They will still need to monitor the kidney function, liver functions. So hopefully in a few days, he has beaten the infection. And then hopefully he can continue his process on weaning off the ventilator, waking up. Can continue the process of physical therapy, range of motions, hopefully mobilization and go from there. So it’s nothing unusual in ICU that it’s often two steps forward, one step back when patients are really severely critically ill.

That is my quick tip for today.

If you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].

Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There you can ask questions 24-hours a day in a membership area and via email to me and my team.

Also, if you need a medical record review for your loved one in ICU or after intensive care, if you suspect medical negligence, you should contact us as well.

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Thanks for watching.

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