The researchers found that 66 of the 186 patients (35 percent) had clinically significant symptoms of PTSD, with the greatest apparent onset occurring by the initial, three-month follow-up visit. Sixty-two percent of the survivors who developed PTSD still had symptoms at their two-year visit. Half of this same group was taking psychiatric medications, and 40 percent had seen a psychiatrist in the two years since being hospitalized with ALI.
The researchers also found that patients with depression before hospitalization were twice as likely to develop PTSD, and that those who spent more time in the ICU were more likely to experience symptoms.
Those who had sepsis (a severe response to infection) during their ICU stay, and those who were given high doses of opiates, were more likely to develop PTSD as well. Those given corticosteroids while in the ICU were less likely to develop PTSD, though the exact reasons why are unknown.
The delirium often associated with ICU stays and post-ICU PTSD may be partially a consequence of inflammation caused by sepsis. This inflammation may lead to a breakdown in the blood-brain barrier, which alters the impact on the brain of narcotics, sedatives and other drugs prescribed in the ICU.
Bienvenu says patients who have these risk factors need special attention. Simply educating them and their primary care doctors about the increased risk for PTSD would be a step in the right direction, he adds.
Each year, almost 1 million patients in the United States are hooked up to ventilators in an ICU, and 200,000 are estimated to develop ALI, usually as the result of infection. The lungs of healthy people allow the easy exchange of gases to enable oxygen t
|Contact: Stephanie Desmon|
Johns Hopkins Medicine