Introduction/Hypothesis: While many intensive care unit survivors report negative long-term psychological outcomes including post-traumatic stress disorder (PTSD), depression, and anxiety, some report a positive transformational outcome associated with the recall of a unique cognitive experience, often referred to using the poorly defined term of near-death experiences (NDE). This aspect of ICU survivorship remains ill understood
Methods: Using descriptive statistics, we examined 42 self-reported cases among critical illness survivors in order to elucidate the specific recalled themes and their frequency.
Results:: 62% were female, with reported age range 3-30 years at the time of critical illness arising from anaphylaxis, lupus flare, drowning, asthma exacerbation, hemorrhage, trauma, and cardiac arrest: The features of the recalled experiences were: 1) a sense of joy and peace (92%), perception of observing a warm light (83%), observing their bodies from above without features of classical autoscopy (i.e. seeing a double of themselves) (83%), going through a tunnel (59%), a self-review and judgment of their life events including their actions and intentions (54%), experiencing a pleasant place, joy, a change in the perception of time, the experience of encountering deceased relatives, and others with compassion, together with an overall feeling of positive life transformation after the event (95%).
Conclusions:: In some ICU survivors, there may be a broad spectrum of cognitive activity and memories from their period of critical illness, that may last many years and lead to greater life- meaning and a positive transformation. These memories contrast with negative psychological outcomes such as PTSD. Instead of NDE a more appropriate term might be transformative experience of death (TED). Further studies are needed to better elucidate the phenomenology of the experience of critical illness, as well as delineating the role of brain activity, implicit and explicit learning, and their relationship with overall psychological outcomes and quality of life.