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Critical care patients with PTSD may need more sedation

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Patients with post-traumatic stress disorder who are being mechanically ventilated require higher sedation levels, according to US researchers.

Researchers from the State University of New York examined the effects of pre-existing PTSD on mechanically-ventilated armed forces veterans while in intensive care.

The group of adult patients with PTSD were matched for age and severity of illness with patients without PTSD, and then compared.

“ICU care should incorporate proper awareness of PTSD, with particular attention to sedation regimen”

Jad Kebbe

Of the 1,569 patients that were identified, patients with PTSD had a longer duration of sedation with benzodiazepines – 3.04 versus 2.43 days – and opiates – 3.29 versus 2.47 days. They also had a higher mean daily dose of propofol.

The results highlight the “necessity” to develop sedation regimens tailored to patients with PTSD, which could help improve their experience in intensive care, said the study authors.

In addition to the findings, a trend toward increased ICU mortality rate in the PTSD group was also seen without a significant difference in the duration of mechanical ventilation.

Based on their findings, the study authors suggested patients with PTSD may “exhibit higher sedation needs”.

“This highlights the necessity to better comprehend the interaction between PTSD and ICU care,” they said.

“Developing sedation regimens tailored to PTSD patients may indeed reduce their sedative requirements and improve their ICU experience and outcome,” they added.

The findings were published earlier this week in the journal Chest and are due to be presented next week at the annual conference of the American College of Chest Physicians in Montréal.

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