The long-term psychological effects of daily sedative interruption on critically ill patients

John P Kress; Brian Gehlbach; Maureen Lacy; Neil Pliskin; Anne S Pohlman; Jesse B Hall

doi:10.1164/rccm.200303-455OC

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The long-term psychological effects of daily sedative interruption on critically ill patients

Journal article

Peer reviewed

The long-term psychological effects of daily sedative interruption on critically ill patients

John P Kress, Brian Gehlbach, Maureen Lacy, Neil Pliskin, Anne S Pohlman and Jesse B Hall

American journal of respiratory and critical care medicine, Vol.168(12), pp.1457-1461

12/15/2003

DOI: 10.1164/rccm.200303-455OC

PMID: 14525802

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Abstract

Critically ill patients often receive sedatives, which may delay liberation from mechanical ventilation and intensive care unit discharge. Daily interruption of sedatives alleviates these problems, but the impact of this practice on long-term psychological outcomes is unknown. We compared psychological outcomes of intensive care unit patients undergoing daily sedative interruption (intervention) with those without this protocol (control). Assessments using (1) the Revised Impact of Event Scale (evaluates signs of posttraumatic stress disorder [PTSD]), (2) the Medical Outcomes Study 36 item short-form health survey, (3) the State-Trait Anxiety Inventory, (4) the Beck Depression Inventory-2, (5) and the Psychosocial Adjustment to Illness score (overall quality of adjustment to current or residual effects of illness) were done by blinded observers. The intervention group had a better total Impact of Events score (11.2 vs. 27.3, p=0.02), a trend toward a lower incidence of PTSD (0% vs. 32%, p=0.06), and a trend toward a better total Psychosocial Adjustment to Illness score (46.8 vs. 54.3, p=0.08). We conclude that daily sedative interruption does not result in adverse psychological outcomes, reduces symptoms of PTSD, and may be associated with reductions in posttraumatic stress disorder.

Stress Disorders, Post-Traumatic - etiology

Respiration, Artificial - methods

Hypnotics and Sedatives - adverse effects

Mental Disorders - chemically induced

Respiration, Artificial - psychology

Humans

Middle Aged

Psychology

Male

Substance Withdrawal Syndrome - complications

Treatment Outcome

Stress Disorders, Post-Traumatic - psychology

Time

Mental Processes - drug effects

Critical Illness - psychology

Mental Disorders - psychology

Adult

Female

Aged

Substance Withdrawal Syndrome - psychology

Details

Title: Subtitle: The long-term psychological effects of daily sedative interruption on critically ill patients
Creators: John P Kress - Department of Medicine, University of Chicago, Chicago, IL 60637, USA. jkress@medicine.bsd.uchicago.edu
Brian Gehlbach
Maureen Lacy
Neil Pliskin
Anne S Pohlman
Jesse B Hall
Resource Type: Journal article
Publication Details: American journal of respiratory and critical care medicine, Vol.168(12), pp.1457-1461
Publisher: United States
DOI: 10.1164/rccm.200303-455OC
PMID: 14525802
ISSN: 1073-449X
eISSN: 1535-4970
Grant note: K23 GM63906 / NIGMS NIH HHS
Language: English
Date published: 12/15/2003
Academic Unit: Neurology; Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984020631402771

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