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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
Today, I have an email from Suzie who says,
“Hi Patrik,
My brother is 27 years old. He has been admitted in intensive care with pancreatitis. He has been admitted in intensive care with pancreatitis. He’s ventilated and he is on dialysis. Will he survive?”
Now, not every patient with pancreatitis will end up in ICU. But obviously, if he did end up in ICU, he is probably septic. He’s probably have had a septic shock secondary to the pancreatitis. There might be other things going on. Often when someone has pancreatitis, they might also be in liver failure, they might have gallbladder issues, and they might have gall stones. I don’t know what else is going on, but very likely your brother is in sepsis or in septic shock, which got him into ICU, which got him ventilated and on dialysis.
Now, I have seen this many, many times. I have worked in critical care for nearly 25 years in three different countries where I also worked as a nurse manager for over 5 years. I have been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. We’ve been advocating and consulting for families in intensive care all over the world.
When you look at our testimonial section, you can see what our clients actually say and I can confidently say we have saved many lives with our consulting and advocacy and it’s also verified on our podcast section where we have done some client interviews, and you can listen to what they have to say there.
Coming back to Suzie’s email, so the first thing is your brother would be nil by mouth. He wouldn’t get any nasogastric tube feeds or probably wouldn’t have a PEG tube. He would probably be on TPN which is Total Parenteral Nutrition, also known as intravenous nutrition. He’s ventilated. He would be in an induced coma. He’s on dialysis, often what happens in septic shock or as part of pancreatitis, he might go into multiorgan failure. Looks like his lungs might be failing, which is why he’s ventilated. It looks like his kidneys are failing, which is why he’s on dialysis. He’s most likely on inotropes or vasopressors, making sure the blood pressure that would have dropped as part of the septic shock is compatible with life.
So, all these things, multi-organ failure, vasopressors, isotopes, dialysis, mechanical ventilation, TPN are all considered as life support which is why he’s in intensive care or in critical care. So, they would be monitoring his pancreas levels such as lipase, amylase, and they would probably be very high. His bilirubin might be very high, and they need to check on his pancreas. They need to do regular ultrasounds. They might be able to do an ERCP (Endoscopic retrograde cholangiopancreatography) and see what they can find there.
But in any case, your brother needs time in a situation like that. What stands in his good graces, I believe, is his young age. He’s only 27 years of age. I think that might hopefully work in his favor, but he will need time to recover and hopefully they can find the right antibiotics to target his pancreatitis. Hopefully by giving him TPN, by not feeding him enterally, that will get his pancreas to heal but only time will tell and there are no quick fixes in a situation like that. You and your family will need to be patient and persistence and not give up.
So, that would be my advice here.
Now, you also have to know that approximately 90% of patients in intensive care survive intensive care and that doesn’t speak about what their quality of life is like after intensive care, but I think your brother has a reasonably good chance that he can survive and get out of ICU life. Of course, there are no guarantees, but as long as they are doing everything that they’re supposed to be doing and they’re trying everything they’re supposed to be trying, I think your brother has a good chance.
Then as the next step, the infection needs to come down, the inotropes and vasopressors need to be reduced and that will go hand in hand with the infection, getting better with them using the right antibiotics for the pancreatitis. Once the infection is getting better and automatically, the inotropes will come down, they will need to po potentially continue the dialysis for a few more days, maybe even for a few more weeks. Like I say, it can take time, but you have to be patient and persistent, and you can’t give up in a situation like that and then hopefully your brother can get over this.
Now, if he’s on high doses of inotropes or vasopressors, they also might want to do an ultrasound of the heart, just making sure there are no further cardiac conditions. They probably also should do an ultrasound of the kidneys and the liver in a situation like that, especially with pancreatitis. Also with pancreatitis, often what you might see is that insulin is needed, glucose needs to be managed, and blood sugar levels need to be managed fairly closely. Because again, the pancreas produces insulin and insulin production will be disturbed during a pancreatitis. So, I wouldn’t be surprised if he’s done an insulin infusion as well, temporarily to manage his blood sugar.
So, just to be prepared and what you what you need to look for is really important in your situation that you’re so that you’re not flying blind. A lot of families in intensive care are simply flying blind because the biggest challenge for them is that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care. I also want to say here, quite clearly, we keep focusing sometimes on the negatives in intensive care. That’s because people come to us when they’re really, really challenged.
Because I’ve worked in intensive care for so long, there’s a lot of good things happening in intensive care. As a matter of fact, the overwhelming majority of cases get out of ICU life, and that’s what ICU is there for. But because the people that are coming to us are so challenged, and that’s why this blog might look like we’re only focusing on the negatives in ICU. And to a degree, we are, because only the families that are really, really challenged in ICU and that feel like their loved one stays, not going anywhere. That’s the people who reach out to us. I’m not forgetting that a lot of things in ICU are actually very positive, but unfortunately, the families that we are dealing with our clients, they are challenged beyond imagination, really. That’s why we’re helping them here at intensivecarehotline.com.
That’s also why we have created a membership for families of critically ill patients in intensive care and you can become a member for our membership at intensivecarehotline.com if you click on the membership link or if you go to intensivecaresupport.org directly. In the membership for families of critically ill patients in intensive care, 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 access to 21 exclusive eBooks and videos that I have personally written, and the videos recorded, and those videos and eBooks will help you to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment while they are a patient in intensive care. Intensive care is an incredibly difficult environment, and that’s why you need every help you can get.
I also offer one-on-one consulting and advocacy for families in intensive care over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I also talk to you and your families directly, of course, but I also talk to doctors and nurses directly. I ask all the questions you haven’t even considered asking when talking to doctors and nurses, and that will help you to make informed decisions, have peace of mind, control, power, and influence making sure your loved one gets best care and treatment. I also represent you in family meetings with intensive care teams.
We also offer medical record reviews in real time so that you can get a second opinion in real time. We also offer 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 send us an email to support@intensivecarehotline.com.
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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.