Do the length of ventilator depends on the cause?

Question

Hi doctor,

Does the length of time in critical care always reflect the severity? Does the length of time on a ventilator depend more on the cause, i.e., longer if lung infection rather than neurological, etc? Can you have severe illness complications and still be in the ICU for a short while?

When I was 21, I had severe uncontrolled tonic-clonic seizures (constant on and off for a day, then lasting over an hour and a half). Apparently, I had every medication that could have been if the last drug did not work, then there was nothing else I could have. Apparently, I then had a cardiac arrest, where the doctor had said it was very difficult to get me back, tried for a long time, my heart was struggling, and I was not breathing.

I was anesthetized and on a ventilator. I had blood gases showing acidosis, high lactate, and also ECG showed ST changes and right axis deviation. The echo showed dilated cardiomyopathy and right ventricular dilatation (this was not there just weeks before), no urine output, apparent renal insufficiency, and blood glucose in the 30s mmol. EEG showed a non-reactive background alpha. Cat scan showed low attenuation temporal lobe. MRI showed matter changes. My family was told to come in immediately in the middle of the night as doctors felt I might not make it, and if I had another seizure would not be able to stop it. I had a do-not-resuscitate order put on. Why did they put not do-not-resuscitate order on me at 21?

I hear of people who were in critical care for much longer. I have memory flashbacks and cannot figure out why the length of stay does not relate to severity. I was on a ventilator for 12 hours, and sedation coma was reduced over two days. I was in for three to four days. I feel it was rushed, and if it had not been, then I may not have gotten the lasting problems I have now.

The word anoxic brain injury has been mentioned. After being in ICU, I have had many problems seizures, ataxia, very brisk hyper reflex is reflexes, more in the legs than arms, Babinski reflex, tremor, myoclonus, altered sensation, numbness of arms down to feet, especially the back of hands. I have memory problems and a different personality. I find it hard to learn new things, etc. Are these common symptoms of anoxic brain injury?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I am so sorry that you went through so much, and I am glad to know that you have made it. You are extremely lucky to have survived all this. It seems like after a persistent seizure, you developed acidosis that pushed you into cardiogenic shock. Very few people come out of it. You are the second case in my 12 years of experience that I have seen communicating.

Ventilators have their own complications, and they can lead to mortality and morbidity, which are more difficult to battle than the real problem; therefore, it is always recommended to wean as soon as possible.

Anoxic brain injury occurs right there and then when the event occurs. Ventilators could only prevent part of it and not the entire process. I was curious to know what brought it on in the first place. Why did you have the seizures? Did you have a seizure disorder or an infection process?

Anoxic brain injury can have various consequences, and yes, it can cause different psychological, motor, and cognitive deficits depending upon which part of the brain was involved.

I hope this helps.

Thank you.