Can a patient experience a loss of taste after a prolonged Intensive Care Unit (ICU) stay?

From the Guidelines

Yes, patients can experience a loss of taste after a prolonged ICU stay, with studies suggesting that up to 36% of patients with COVID-19 may experience anosmia, hyposmia, or dysgeusia 1. This symptom is relatively common and can result from multiple factors associated with critical illness and ICU treatment. Mechanical ventilation, which often requires endotracheal intubation, can cause direct trauma to taste receptors and olfactory pathways. Medications commonly used in the ICU, including certain antibiotics, sedatives, and vasopressors, may alter taste perception as a side effect. Critical illness itself can cause systemic inflammation that affects sensory function, while nutritional deficiencies that develop during prolonged illness can impair taste cell renewal. Additionally, neurological complications from critical illness or underlying conditions may damage neural pathways involved in taste perception. Some key points to consider include:

• The high prevalence of malnutrition in ICU patients, with up to 65% of patients admitted to the ICU with COVID-19 being malnourished 1
• The importance of nutrition therapy in critical illness, with oral nutrition being the most common type of nutrition therapy in the post-ICU phase 1
• The need for individualized nutrition management, as non-individualized processes can impact nutrition adequacy in the post-ICU period 1 Recovery of taste function typically occurs gradually over weeks to months after ICU discharge, though some patients may experience persistent alterations. Treatment approaches include zinc supplementation if deficient, gradually reintroducing varied flavors and textures in the diet, maintaining good oral hygiene, and in some cases, referral to specialists such as ENT physicians or neurologists if symptoms persist beyond several months. It is essential to prioritize the patient's nutritional needs and provide individualized care to minimize the risk of malnutrition and support recovery. The evidence suggests that a comprehensive approach to nutrition management, including assessment and intervention, is crucial in the ICU and post-ICU phases to optimize patient outcomes 1.

From the Research

Loss of Taste after Prolonged ICU Stay

• There is limited research directly addressing the loss of taste after a prolonged Intensive Care Unit (ICU) stay.
• However, studies have investigated taste disorders in various contexts, including post-traumatic gustatory deficits 2 and taste changes associated with medical procedures 3, 4.
• These studies suggest that taste disorders, such as hypogeusia (reduced taste) or ageusia (loss of taste), can occur due to various factors, including head trauma, medication use, and nerve damage.
• In the context of ICU stays, patients may be at risk for developing taste disorders due to factors such as nosocomial sinusitis 5, which can lead to inflammation and potentially damage the senses of taste and smell.
• Additionally, exposure to toxic substances, such as those found in urban and industrial air pollution, can also impact the senses of taste and smell 6.
• While there is no direct evidence linking prolonged ICU stays to loss of taste, it is possible that patients may experience taste disorders due to the various medical interventions and exposures they receive during their stay.