Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So today’s tip is about paralyzing agents in intensive care. So why do I bring this up as a topic you may never have heard of that if you have a loved one in intensive care. The reason I bring this topic up today is simply a lot of families in intensive care come to us and they want to know how long does it take to wake up after an induced coma?
And especially if there are delays in waking up, sometimes your loved one may have received paralyzing agents while in an induced coma, and that usually leads to heavier sedation, which then also leads to a longer wake up period after an induced coma.
So again, as you may have heard me say before, the biggest challenge for families in intensive care is simply that you don’t know what you don’t know and that you don’t know what to look for. And you don’t know what questions you need to ask. And this is exactly one of those questions where you simply don’t know what you don’t know and you may have never heard about what I’m going to share with you.
So if your loved one is in ICU with a condition like ARDS also known as acute lung failure or if your loved one is in ICU with high oscillation ventilation or ECMO, this all usually goes hand in hand with difficult ventilation. And if your loved one is trying to breathe up, even in an induced coma, it may actually hinder a recovery because they’re breathing against the ventilator.
And if that’s the case, you know, your loved one may need to be paralyzed, which means he will receive, he or she will receive paralyzing agents that basically stop every movement. If that’s the case, you know, ventilation is usually improved because your loved one will stop fighting the ventilator and the mechanical ventilator can do it’s more or less magic and can do the work for your loved one.
If your loved one is having paralyzing agents, again, you know, sedation is usually increased and that may then also delay the waking up process. Other situations that lead to paralyzing agents and your loved one being paralyzed is, for example, prone positioning.
And again, that is often going hand in hand with ARDS and also high PEEP. PEEP is one form of a pressure on the ventilator, and if that PEEP is high, patients often need to be paralyzed as well because it’s very uncomfortable.
Other situations that could lead to paralyzing agents is TBI or traumatic brain injury with high intracranial pressure. So if the pressure is high in the brain, often paralyzing agents need to be used as well. It’s therefore also diminishing the risk for those high pressures to occur in the first place. And also it diminishes the risk for barotrauma or pneumothorax or when your loved one has high pressures in the lungs and has high PEEP.
Other situations where paralyzing agents might be used is an open chest. You know, if your loved one, God forbid, has an open chest after open heart surgery, for example. Paralyzing agents are often used as well again to minimize any movement. Again, the main side effect is that really sedation needs to be increased and therefore, your loved one may even need longer to wake up.
So that’s my quick tip for today about paralyzing agents.
It’s Patrik Hutzel here from intensivecarehotline.com. Thanks for watching and I’ll talk to you in a few days.