Relationship between sedation, delirium, and post-traumatic stress disorder among mechanically ventilated patients
Keywords:
Sedation, delirium, post-traumatic stress disorder, mechanically ventilated patientsAbstract
Background: Delirium is a significant medical condition that is common among patients in intensive care units. Beyond the increased risk of mortality, patients who experience an episode of delirium often go on to develop long-term psychiatric disturbance, including symptoms of post-traumatic stress disorder (PTSD). Aim: To investigate the relationship between sedation, delirium and post-traumatic stress disorder among mechanically ventilated patients. Design: A descriptive correlational research design was utilized in this study. Setting: The study was carried out at different intensive care units at Cairo university hospitals with different specialties. Sample: A purposive sample of 110 patients was included in the study over a period of three months. Tools: Four tools were used; Patient’s Demographic and Medical Data Sheet, Richmond Agitation Sedation Scale (RASS), The Intensive Care Delirium Screening Checklist (ICDSC) and Post-Traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5). Results: About (74.5%) of the studied sample had PTSD. There was negative statistical significant correlation between sedation and post-traumatic stress disorder. There was positive statistical significant correlation between delirium and post-traumatic stress disorder. There was no statistical significant correlation between delirium and sedation. Conclusion: This study provides a complex picture of the relationship between delirium, sedation and PTSD.
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Arthur, Kwizera, Nakibuuka, J., Ssemogerere, L., Sendikadiwa, C., Obua,D., Kizito, S., … & Nakasujja, N. (2015). Incidence and Risk Factors for Delirium among Mechanically Ventilated Patients in an African Intensive Care, Critical Care Research and Practice, 7. http://dx.doi.org/10.1155/2015/491780
Bergeron, N. Dubois, M. J., Dumont, M., Dial, S., & Skrobik, Y. (2001). Intensive care delirium screening checklist: evaluation of a new screening tool. Intens Care Med., 27, 859-864.
Brummel, N.E., Boehm, L.M., Girard, T.D., Pandharipande, P.P., Jackson, J.C., & Hughes, C.G., et al. (2017). The Relationship Between subsyndromal and Clinical Outcomes after Critical Illness. American Journal of Crit Care.
Bulic, D., Bennett, M., Georgousopoulou, E. N. et al. (2021). Cognitive and Psychosocial Mechanically Ventilated in Intensive Care patients with and without delirium. Ann Intensive Care, 10, 104 .
Bulic, D., Bennett, M., Rodgers,H., Nourse, M., Rubie, P., CL Looi J., & Van Haren F. (2017). Delirium After Mechanical Ventilation in Intensive Care Units: The Cognitive and Psychosocial Assessment (CAPA) Study Protocol. JMIR, 6, 2 ,31 .
Denke, C., Balzer, F., Menk, M., Szur, S., Brosinsky, G., Tafelski1, S., … & Maria, D. (2018). Long-term sequelae of acute respiratory distress syndrome caused by severe community- acquired pneumonia: Delirium-associated cognitive impairment and post-traumatic stress disorder. Journal of International Medical Research, 46(6) 2265–2283.
Ehlers, A., & Clark, D.M. (2000). In Denke, C., Balzer, F., Menk, M., Szur, S., Brosinsky, G., Tafelski1, S., … & Maria, D. (2018). A cognitive model of posttraumatic stress disorder. Behav Res Ther., 38, 319–345.
Girard, T.D., Shintani, A.K., Jackson, J.C. et al. (2017). Risk factors for post-traumatic stress disorder symptoms following critical illness requiring mechanical ventilation: a prospective cohort study. Crit Care, 11, R28 .https://doi.org/10.1186/cc5708
Grover, S., Sahoo, S., Chakrabarti, S. & Avasthi, A. (2019). Post-traumatic stress disorder (PTSD) related symptoms following an experience of delirium. Journal of Psychosomatic Research, 123, 109725.
Hatch, R.,Young, D., Barber, V., Griffiths, J., Harrison, D., & Watkinson, P. (2018). Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: A UK- wide prospective cohort study. Critical Care, 22, 310. https://doi.org/10.1186/s13054-018-2223-6
Junior, M.M., Kumar, A., Kumar, P., & Gupta, P. (2022). Assessment of Delirium as an Independent Predictor of Outcome among Critically Ill Patients in Intensive Care Unit: A Prospective Study. Indian J Crit Care Med, 26(6), 676-681.
Langan et al. (2017). Psychiatric symptomatology after delirium: A systematic review. Psychogeriatrics.
Marra, A. Pandharipande, B. B. & Patel, M. B. (2017). ICU Delirium and ICU-related PTSD. Surg Clin North Am., 97(6), 1215–1235.
National Center for PTSD (2013). The PTSD Checklist for DSM-5 (PCL-5). at www.ptsd.va.gov
Partners In Health, (2015). Introduction to Agitation, Delirium and Psychosis: Participant Handbook. P.1.
Patel, M.B., Jackson, J.C., Morandi, A., Girard, T.D., Hughes, C.G., Thompson, J.L., & Pandharipande, P.P. (2016). Incidence and Risk Factors for Intensive Care Unit-related Post-traumatic Stress Disorder in Veterans and Civilians. Am J Respir Crit Care Med. Jun 15;193(12), 1373-81. Doi. 10.1164/rccm.201506-1158OC.
Rasheed, A.M., Amirah, M., Abdallah, M., Awajeh, A., Parameaswari, P. J., & Al Harthy, A. (2019). Delirium incidence and risk factors in adult critically ill patients in Saudi Arabia. J Emerg Trauma Shock,12, 30-4
Schulingkamp, D., Woo, S., Nguyen, A., Sich, N., & Shadis, R. (2016). Assessment of continuous sedation versus intermittent sedation in mechanically ventilated patients. Crit Care Med, 44, 292.
Sessler, C.N., Gosnell, M., Grap, M.J., Brophy, G.T., O'Neal, P.V., Keane, K.A. et al. (2002). The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care patients. Am J Respir Crit Care Med, 166,1338-1344.
Svenningsen, H. (2013). Associations between sedation, delirium and post-traumatic stress disorder and their impact on quality of life and memories following discharge from an intensive care unit. Danish Medical Journal., 60(4), B4630.
Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnur, P.P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www.ptsd.va.gov.
Wolters, A. E., Peelen, L. M., Welling, M. C., Kok, L., de Lange, D. W., Cremer, O. L., …,& Veldhuijzen, D. S. (2016). Long-term mental health problems after delirium in the ICU. Critical Care Medicine, 44, 1808–1813. https ://doi.org/10.1097/CCM.00000 00000 00186
Yahya, Shehabi , Bellomo, R., Reade, M. C., Bailey, M., Bass, F., Howe, B., …& Leonie Weisbrodt, L. (2013). Sedation Practice in Intensive Care Evaluation Study Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group. Crit Care Med, 41(8), 1983-91. doi: 10.1097/CCM.0b013e31828a437d
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