Quick Tip for Families in Intensive Care:
Multiple Sclerosis, ICU, Dialysis, and Ventilator Challenges Explained

Multiple sclerosis, ICU, dialysis, and ventilator challenges explained in this video.

My name is Patrik Hutzel from intensivecarehotline.com, where we provide solutions for families of critically ill patients in intensive care, so that you can make informed decisions, have peace of mind, control, power, and influence, even if you’re not a doctor or a nurse in intensive care. So that the loved one gets best care and treatment always when they are critically ill in intensive care.

So, today I want to answer a question from one of our readers who asked,

“Can you give possible information on multiple sclerosis? My family member has been in ICU for 2 weeks after an emergency. Now the access is clotted for dialysis. Now the access port in the groin for intravenous fluids and dialysis are now going to the neck. Is that the best place to be?

My family member suffered cardiac arrest during tries of dialysis. Heart rate and blood pressure have been unstable, and there has been some body inflammation. There has been some periodic natural breathing, but mainly ventilator trigger, that means the ventilator is doing most of the work. Recent CT scan results are clear. But now, the ICU team is considering an MRI. My family member is on moderate sedation due to patient frustrations. They’re very agitated. Thanks in advance for your insight.”

So, here’s my take. First of all, it sounds like your loved one has multiple very complex issues going on in ICU.

So, let’s break them down.

1.  Multiple sclerosis, MS, and ICU stay.

MS itself is usually a long-term neurological degenerative condition that can flare up, but it’s not typically the direct reason for needing ICU. What’s happening here sounds more related to the cardiac arrest, kidney failure requiring dialysis, unstable blood pressure, and the need for a ventilator. MS may complicate recovery, but it’s not usually the main driver of this current ICU stay.

And just as a side note, the email from the reader has been all over the place, and now, that’s great that you’re writing in.

But it just goes to show that the biggest challenge for families in intensive care is simply 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.

You need access to the medical records, and you need to share medical records with professionals, like us here at intensivecarehotline.com, so that you can get a second

Now, let’s continue to break this down.

2.  Dialysis and vascular access.

You mentioned the clotted dialysis line, which is common in ICU. That’s why they moved access from the groin to the neck. Neck access via the internal jugular vein is standard for dialysis in ICU because it’s safer long term and has a lower infection risk compared to the groin. Imagine in ICU when patients are incontinent, and, for example, the groin gets soiled with diarrhea or stools, etc. There’s a huge risk of infection.

3.  Cardiac arrest and instability.

After a cardiac arrest, it’s very common for patients to have unstable blood pressure, heart rhythm issues, and inflammation throughout the body. This requires ongoing support with medications such as vasopressors, sedation, etc.

4.  Ventilation support.

Periodic natural breathing is a good sign, but being mainly ventilator dependent means the lungs and overall condition are still fragile. The ICU team will want to assess how much natural breathing can be encouraged, but this takes time and depends on heart, kidneys, and brain function stabilizing.

Also, keep in mind that if your family members can’t be weaned off the ventilator, especially if they’re weak because they’re deconditioned with an induced coma, there might also be because of the MS (multiple sclerosis). A tracheostomy might be needed.

5.  Sedation and frustration.

It’s very common for ICU patients to become agitated, especially when they are on a ventilator. Moderate sedation is often used to keep them comfortable and prevent self-harm, like pulling out lines or tubes.

6.  Scans, CT and MRI.

A clear CT scan is reassuring, and an MRI may provide more detail, particularly about brain function after cardiac arrest or about the impact of MS.

In summary, your loved one is facing a combination of issues, multiple sclerosis, kidney failure needing dialysis, complications from a cardiac arrest, and reliance on a ventilator, including being in an induced coma and depending on vasopressors and inotropes. Each of these factors is serious on its own, but together they make recovery slower and more complex.

The fact that natural breathing is happening somewhat, and the CT is clear, are positives. The key now is stabilization of heart and kidneys, ongoing dialysis, and careful reduction of sedation and vasopressors, inotropes to assess neurological status more fully. It’s also important that diagnostics such as a cardiac ultrasound are being done to assess the ejection fraction or the contractility of the heart.

Again, the biggest challenge for families in intensive care is that they don’t know what they don’t know. And that is why it’s so important for you to get access to the medical records as soon as possible and get a second opinion.

After having worked in critical care nursing for over 25 years, I am under the strong opinion that intensive care teams are not even telling you half of what’s going on, unless you know what questions to ask, unless you know what to look for, unless you get professional help. They’re only telling you half of what’s happening, so they can stay in control of the narrative, so that you don’t see all the options that are available to you, or that you don’t see all the options available for treatment for your loved one, so that they can start talking about end of life whenever it suits them. Keep that in mind.

What you see in ICU is not always what you get. So if you have a loved one in intensive care and you need help navigating complex situations like that, contact us at Intensivecarehotline.com, because we can guide you step by step so you can make informed decisions, have peace of mind, control, power, and influence, even if you’re not a doctor or a nurse in intensive care, in a situation that often feels overwhelming, so that your loved one always gets best care and treatment.

I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse 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 with our consulting and advocacy because of our insights. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we have done client interviews because our advice is absolutely life changing.

The biggest challenge for families in intensive care is simply 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.

That’s why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. When I talk to families directly, I also talk to doctors and nurses directly, asking 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 also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if in case you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have a membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com, if you click 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 have personally written and recorded. All of that will help you to improve your life instantly, make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment always.

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 [email protected] 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.