(109) ARDS Survivors’ Post-ICU Vivid Memories and Sensory Triggers: Qualitative Study Results

Introduction: Intensive care unit (ICU) admissions can be traumatic for adult, critically ill, ventilated patients with acute respiratory distress syndrome (ARDS). Survivors of ARDS are at higher risk of developing psychological trauma symptoms than those with other critical illnesses due to their longer lengths of stay, ventilator requirements, severity of illness, and heightened risk for delirium. This study explored ARDS survivors’ ICU memories and sensory triggers for them.

Methods: Semi-structured interviews with open-ended questions were conducted with adult ARDS survivors hospitalized in an ICU on a ventilator between 2020 and 2024. Participants were recruited from survivorship groups. Thematic analysis was used to identify the most prevalent themes for survivors’ responses to the following questions: 1) What is your most vivid memory from the ICU? 2) Are there any things you see, hear, smell, or touch that trigger memories of your time in the ICU?

Results: Thirty-five survivors participated in the study. The mean age was 43.4 years; most survivors were white (91%), non-Hispanic (86%), and female (57%). Survivors’ median days from discharge at time of interview was 337.5 days (34-993). Five main themes and 17 subthemes emerged: 1) altered reality “dreams” while under sedation; 2) experiences of death and dying; 3) loss of control; 4) bedside interactions; and 5) triggers reminding survivors of real ICU environmental exposures and events. Common memory triggers included: 1) medical and non-medial media; 2) cleaning products and linens; 3) medical device scars; 4) loud, unexpected sounds; and 5) situations encountered after discharge (e.g., driving by the hospital).

Conclusions: Vivid memories in survivors of ARDS included real and unreal events. Memories were provoked by both medical and non-medical sensory triggers. We recommend further study of ICU memories in diverse populations. It is important for interdisciplinary team members to be aware of the long-term psychological trauma symptoms experienced by ARDS survivors. Evidence-based interventions, such as the ICU liberation bundle, should be adopted to reduce delirium and potentially prevent or limit post-ICU trauma. This study highlights the need for mental health screening post-ICU in acute care and outpatient settings.