ICU Memories in Survivors of Acute Respiratory Distress Syndrome During COVID-19: A Qualitative Study

Survivors of acute respiratory distress syndrome (ARDS) frequently report vivid memories of their hospitalization. These memories can cause intense physical and emotional reactions. The COVID-19 pandemic contributed to a dramatic increase in ARDS incidence, but few studies have explored the nature and triggers of memories in postpandemic ARDS survivors.

This qualitative study aimed to analyze the vivid memories and explore the multisensory memory triggers of adult ARDS survivors who received mechanical ventilation in the ICU between 2020 and 2023, during the COVID-19 pandemic.

An interpretative phenomenological design was used. Semistructured interviews were conducted in person or via videoconference. Participants were asked to describe their most vivid memory from their ICU stay and any visual, auditory, olfactory, and tactile triggers of ICU-related memories. Interview data were analyzed using thematic analysis.

A total of 35 ARDS survivors were interviewed. Five major themes and 17 subthemes emerged from the data. Major themes included the following: altered reality "dreams" while under the effects of sedation, recalled experiences of death, loss of control, bedside interactions, and multisensory triggers reminding survivors of real ICU environmental exposures and events. Nearly half the participants (n = 16; 46%) reported dreams as their most vivid memory. The term dreams was used because it was often unclear whether the memories occurred while participants were asleep or in a delirious state. Most participants (n = 31; 89%) reported at least one sensory memory trigger, with visual and auditory triggers the most common. Triggers often prompted the recall of factual ICU-related memories.

Understanding the content and triggers of memories experienced by ARDS survivors can help guide nursing care across the health care continuum and facilitate interventions geared toward prevention and recovery.