Puntillo KA, Arai S, Cohen NH, Gropper MA, Neuhaus J, Paul SM, Miaskowski C. "Symptoms experienced by intensive care unit patients at high risk of dying." Critical Care Medicine. 2010; 38: 2155-60.
- In the U.S., almost one in five deaths occurs during or shortly after a stay in an intensive care unit (ICU).
- Patients in an ICU often have difficulty communicating for reasons such as the severity of their condition, the effects of pain medications and sedatives, and/or being on a mechanical ventilator. Thus, they may experience symptoms that go unrecognized and untreated.
- Researchers conducted brief surveys of 171 seriously ill ICU patients to measure the prevalence, intensity, and related distress of ten common symptoms.
- The most frequently reported symptoms were tiredness (75%), thirst (71%), and anxiety (58%), with thirst rated as the most intense.
- The symptoms causing the most distress were shortness of breath, pain, and feeling scared or confused.
- Of 152 patients who were able to complete a further neurologic assessment, 34% had experienced an episode of delirium, as indicated by an acute change in mental status, inattention, disorganized thinking, and an altered level of consciousness.
- These findings indicate that patients in the ICU may experience significant symptoms of varying degrees of intensity and distress. Greater attention to symptom assessment by clinicians may help to improve treatment and avoid unnecessary suffering.
R01 NR008247/NR/NINR NIH HHS/United States
About the Researcher:
University of California, San Francisco (UCSF)
School of Nursing
Dr. Kathleen Puntillo is Professor of Nursing at University of California, San Francisco. She has a long-standing program of research on pain in critically ill and injured patients. Currently she is conducting a European Society of Intensive Care Medicine-funded international study of procedural pain and an NIH-funded study of thirst in ICU patients. She publishes and lectures extensively on the topics of pain and other symptoms, ICU communication, and palliative care. Dr Puntillo is a Fellow in the American Academy of Nursing and maintains her clinical practice in critical care nursing.