Sedation influence on posttraumatic stress disorder (PTSD) incidence after ICU discharge

Abstract

Alcohol withdrawal patients have increased risk of PTSD after ICU discharge. The aim of this study was to determine the PTSD incidence in AWS patients after ICU discharge and to investigate the stress marker dynamics – plasma cortisol during the course of treatment, depending on the chosen sedation method. To the prospective controlled study were admitted 200 AWS patients in 4 groups – dexmedetomidine (gr. 1.1), propofol (gr. 1.2) dexmedetomidine and propofol (hr.1.3) and control (gr. 1.4). PTSD incidence 1 month after discharge was as follows: in groups 1.1-1.3 in 3-7% patients, in group 1.4 – 15 (35%) patients had PTSD (p = 0.003). PTSD incidence 6 months after discharge was lower in groups 1.1-1.3 – 4-7% patients; in group 1.4 – 39% of patients had PTSD (p = 0.006). 48 hours after inclusion in the study cortisol level significantly decreased in groups 1.1-1.3 and increased in group 1.4 (rd”0,001). 72 hours after inclusion in the study cortisol level also significantly decreased in group 1.1-1.3 and remained high in the control group 1.4 (rd”0,001). Dexmedetomidine, propofol and their combination use for AWS patients sedation reduces the level of stress hormones and PTSD incidence.