The impact of sedation and analgesia on post-ICU syndrome: Experience from a post-critical care follow-up clinic.

OBJECTIVE

To evaluate physical, cognitive, and psychological complications in critically ill patients following ICU stay and analyse their relationship with sedation and analgesia.

METHODS

Prospective study including 94 ICU patients. Demographic data, comorbidities, reason for admission, complications, and treatments were recorded, along with functional, cognitive, and psychological assessments at discharge. The relationship between doses and duration of sedatives and opioids with muscle weakness, delirium, nightmares, and cognitive impairment was analysed.

RESULTS

The mean age was 61.4 years, with a predominance of males (52.1%). Most patients were admitted for medical conditions (81.9%), mainly pneumonia (46.8%) and sepsis (11.7%). The most frequent complications were acquired weakness (73.4%), delirium (52.1%), and sleep disturbances (37.6%). Mechanical ventilation was applied in 85.1% of patients, 48.9% received early rehabilitation, and the mean ICU stay was 21.98 days. At discharge, functional assessment showed moderate impairment (Barthel 81.97; EQ-5D 0.72), and 54.3% had MoCA <26. Patients exposed to higher doses and longer duration of midazolam and opioids more frequently developed weakness and nightmares. Delirium was associated with longer sedation, while cognitive impairment showed no significant association with sedoanalgesia.

CONCLUSION

Critically ill patients frequently experience weakness, delirium, and cognitive alterations after ICU stay. The intensity and duration of sedoanalgesia may influence certain sequelae, highlighting the importance of individualized pharmacological management and early rehabilitation strategies.