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In the ICU, use of benzodiazepines, other factors may predict severity of post-stay depression
Date:4/10/2009

ients with ALI typically require invasive interventions in the ICU, including use of ventilators. Though better care has greatly reduced mortality rates, ALI still kills about 40 percent of those affected.

Bienvenu and his colleagues followed 160 patients who had survived at least six months after their ALI diagnosis. The researchers took note of a variety of features of each patient's status and care while in the ICU, such as severity of organ failure, their blood sugar levels and other lab work, and the amount and type of sedative they received.

At six months after ALI diagnosis, the researchers administered a questionnaire to patients that measured depressive symptoms ranging from none to possible or probable clinical depression. Of the 160, 26 percent scored above the threshold for possible depression. Compared to other ALI survivors, the depressed patients were more likely to have suffered greater severity of organ failure and to have received 75 mg or more of a benzodiazepine sedative daily.

Bienvenu says that because more severe organ failure may lead to a longer physical recovery period after ICU discharge, patients' depression may be explained, in part, by a slow recovery. However, he and his colleagues aren't sure how to explain the association between depression and ICU benzodiazepine dose.

One possibility could be that the amount of this drug received reflects how agitated patients were in the ICU, with very distressed individuals getting higher doses. However, because this relationship hasn't been seen with other types of sedatives commonly prescribed in the ICU, it's possible that high doses of benzodiazepine alone may somehow cause depressive symptoms. "This is clearly a question that needs further study," says Bienvenu.


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Contact: Christen Brownlee
cbrownlee@jhmi.edu
410-955-7832
Johns Hopkins Medical Institutions
Source:Eurekalert

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