Background: In intensive care, mechanical ventilation is a common treatment for critically ill patients. Patients are often treated with both sedative and pain-relieving drugs, which together with invasive mechanical ventilation puts the patient in a particularly vulnerable situation as the ability to verbally communicate is limited. This makes it difficult for both the intensive care nurse and relatives to know what the patient remembers and how they have experienced their time with mechanical ventilation.

Aim: To review and synthesize qualitative studies that have explored adult patients' memories of their time with invasive mechanical ventilation in an intensive care unit.

Method: A structured literature review with qualitative design. Structured searches were conducted in the databases PubMed, CINAHL and Psychinfo, which resulted in 18 articles of qualitative design and mixed method and published between the years 2009-2024. Included articles are quality reviewed according to Caldwell's review template and the results of the articles are analyzed using an inductive thematic analysis.

Results: The results present two main themes with associated subthemes. The main theme In the shadow of suffering had associated subthemes Pain and discomfort and An unreal existence. The main theme Abandoned in a strange environment had associated subthemes Voiceless in a world of sound and Seeing yourself fragile through the eyes of others.

Conclusion: Patients' memories of the time in the intensive care unit with invasive mechanical ventilation vary, but overall the period is described as heavy and psychologically stressful. Communication and information from relatives and healthcare professionals is crucial for patients' well-being, and intensivecare nurses have an important role in supporting and including relatives in care. A professional approach to nursing care, regardless of whether the patient is sedated or awake, is essential for as pleasant an experience as possible.