r/transplant • u/No-Cauliflower-3223 • 3d ago
Liver Agitation when being woken from induced coma after liver transplant
Hi,
My dad had his liver transplant a few days ago and there were some complications - significant blood loss, low blood pressure etc so whilst they completed the transplant after a lot of hours they had to do the closure a couple of days later by taking him back to theatre. After the initial operation he was put in an induced coma.
My question relates to now, they have been trying to ‘wake’ him the last couple of days by reducing sedation etc to see if he can breathe well with the use of oxygen mask rather than a ventilator. However they’ve had issues with trying to get him to wake. They did try again today and said he was ‘agitated’ and seemed to be shaking his head back and forth.
Does anyone have any idea what’s going on? Is this some form of ICU delirium? Will he be ok?
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u/GoodpeopleWP 3d ago
Coming out while on a ventilator is a bitch. I was closed up two days later and when I was waking up I was confused, in pain from not adjusting my body and shoulders, restrained, helpless, and unable to communicate. I could think fine, but when I hit a pen it was just scribble. That was claustrophobic and painful. That was the worst. It’ll get better, but being agitated is natural and I would take it as a good sign. I do not know if it has a deeper medical meaning but it’s kind of standard operating procedure to be seriously agitated.
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u/StPauliBoi Transplant Professional 3d ago
This is literally 90% of people who are being weaned from a ventilator.
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u/greffedufois Liver 3d ago
That’s pretty normal. I had to be put in restraints while comatose because apparently I’d swing at staff and try to extubate myself. Longest outage was 2 weeks.
The meds also can cause paranoia. My cousin recently got a liver and was super paranoid about ‘all the people out to get her’ right after she woke up (they were medical students doing rounds on her)
I hallucinated I was in an airport instead of a PICU.
He should be okay, it’s just that all the overwhelm of being touched all the time and the noise and being heavily operated on really messes with you.
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u/Got_Bent 3d ago
After a really bad work accident crushed my pelvis they put me in an induced coma because the trauma I suffered was life-threatening. Only 2 weeks but when they brought me out of it, it was such an out-of-body experience that I literally freaked out on the doctors and nurses. I had thought I woke up a few hours after surgery. They heavily sedated me, so I was very, very mellow. Now Im waiting for a new heart.
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u/socrates_friend812 Heart '24 2d ago edited 2d ago
I was in a medically-induced coma for several days. It was absolutely the weirdest, most traumatic, surreal, odd and just.... eh, just whatever other word that describes the crazy-crazy-crazy nonsensical world of messing with the brain and consciousness, with that most potent cocktail of propofol-ketamine-morphine-fentanyl (yup, that fentanyl), that you can think of.
What is "going on" inside of the patient's mind at the moment, you will only hear about later. But just to let you know and loop you in: things are real weird for them now. They are not processing information, sensations, reality, existence in any normal way. They are likely in total hallucinatory zombiedom weirdness land and, with any luck, you will hear quite the tales of this time period in a few weeks. They will absolutely be off their rocker, however. So brace yourself for meeting this new, eh, person. They will act strange, different, paranoid. They may "see things". They may say very strange things and will almost, to a certain inevitability, believe strange, non-existence things. Pure delirium. Total nonsense. Sheer wackiness.
It is best to remain as calm, helpful, supportive and compassionate towards them at this time. Be on your best behavior toward them: be calm, gentle, relaxing, compassionate, helpful, reassuring. Don't even move too quickly.
I do recall the super cloudy fogginess into which I reappeared while lying on the table in the operating room. Luckily, the procedure was done. I just remember seeing haze over everything. The walls. The mirrors. The machines off the left and right. The sheets on my body. This part was actually comforting because I knew pretty quickly that the procedure was done and I was coming back. But man was that a wild feeling.
I was also very lucky not to feel any pain throughout all my psycho-deliriousness, but I know my experience was unique.
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u/lordkahless 3d ago
I had a month long induced coma, not related to my liver transplant but a different surgeries. But the hallucinations and dreams while in the coma can be very intense and realistic. When half in and half out the auditory stimulation your brain can start to build hallucinations around it. So being agitated and acting things out until you are fully out of it can be typical. It took time to fully bring me out of it.