TY - JOUR
T1 - Association of analgosedation with psychiatric symptoms and health-related quality of life in ARDS survivors
T2 - Post hoc analyses of the DACAPO study
AU - The DACAPO Study Group
AU - Blecha, Sebastian
AU - Zeman, Florian
AU - Rohr, Magdalena
AU - Dodoo-Schittko, Frank
AU - Brandstetter, Susanne
AU - Karagiannidis, Christian
AU - Apfelbacher, Christian
AU - Bein, Thomas
AU - Bickenbach, Johannes
AU - Beeker, Thorben
AU - Schürholz, Tobias
AU - Pezechk, Jessica
AU - Schloer, Jens
AU - Jaschinski, Ulrich
AU - Kummer, Ilse
AU - Kuckein, Oliver
AU - Weber-Carstens, Steffen
AU - Goldmann, Anton
AU - Angermair, Stefan
AU - Stoycheva, Krista
AU - Brederlau, Jörg
AU - Rieckehr, Nadja
AU - Schreiber, Gabriele
AU - Haennicke, Henriette
AU - Bach, Friedhelm
AU - Gummelt, Immo
AU - Haas, Silke
AU - Middeke, Catharina
AU - Vedder, Ina
AU - Klaproth, Marion
AU - Adamzik, Michael
AU - Karlik, Jan
AU - Martini, Stefan
AU - Robitzky, Luisa
AU - Putensen, Christian
AU - Muders, Thomas
AU - Lohmer, Ute
AU - Dembinski, Rolf
AU - Schäffner, Petra
AU - Wulff-Werner, Petra
AU - Landsiedel-Mechenbier, Elke
AU - Nickoleit-Bitzenberger, Daniela
AU - Silber, Ann Kathrin
AU - Ragaller, Maximilian
AU - de Abreu, Marcello Gama
AU - Ulbricht, Alin
AU - Reisbach, Linda
AU - Zacharowski, Kai
AU - Meybohm, Patrick
AU - Friederich, Patrick
N1 - Publisher Copyright:
© 2022 Blecha et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2022/10
Y1 - 2022/10
N2 - Background The acute respiratory distress syndrome (ARDS) is a life-threatening condition with the risk of developing hypoxia and thus requires for invasive mechanical ventilation a long-term analgosedation. Yet, prolonged analgosedation may be a reason for declining health-related quality of life (HRQoL) and the development of psychiatric disorders. Methods We used data from the prospective observational nation-wide ARDS study across Germany (DACAPO) to investigate the influence of sedation and analgesia on HRQoL and the risk of psychiatric symptoms in ARDS survivors 3, 6 and 12 months after their discharge from the intensive care unit (ICU). HRQoL was measured with the Physical and Mental Component Scale of the Short-Form 12 Questionnaire (PCS-12, MCS-12). The prevalence of psychiatric symptoms (depression and post-traumatic stress disorder [PTSD]) was assessed using the Patient Health Questionnaire-9 and the Post-Traumatic Stress Syndrome-14. The associations of analgosedation with HRQoL and psychiatric symptoms were investigated by means of multivariable linear regression models. Results The data of 134 ARDS survivors (median age [IQR]: 55 [44–64], 67% men) did not show any significant association between analgosedation and physical or mental HRQoL up to 1 year after ICU discharge. Multivariable linear regression analysis (B [95%-CI]) yielded a significant association between symptoms of psychiatric disorders and increased cumulative doses of ketamine up to 6 months after ICU discharge (after 3 months: depression: 0.15 [0.05, 0.25]; after 6 months: depression: 0.13 [0.03, 0.24] and PTSD: 0.42 [0.04, 0.80)]). Conclusions Up to 1 year after ICU discharge, analgosedation did not influence HRQoL of ARDS survivors. Prolonged administration of ketamine during ICU treatment, however, was positively associated with the risk of psychiatric symptoms. The administration of ketamine to ICU patients with ARDS should be with caution.
AB - Background The acute respiratory distress syndrome (ARDS) is a life-threatening condition with the risk of developing hypoxia and thus requires for invasive mechanical ventilation a long-term analgosedation. Yet, prolonged analgosedation may be a reason for declining health-related quality of life (HRQoL) and the development of psychiatric disorders. Methods We used data from the prospective observational nation-wide ARDS study across Germany (DACAPO) to investigate the influence of sedation and analgesia on HRQoL and the risk of psychiatric symptoms in ARDS survivors 3, 6 and 12 months after their discharge from the intensive care unit (ICU). HRQoL was measured with the Physical and Mental Component Scale of the Short-Form 12 Questionnaire (PCS-12, MCS-12). The prevalence of psychiatric symptoms (depression and post-traumatic stress disorder [PTSD]) was assessed using the Patient Health Questionnaire-9 and the Post-Traumatic Stress Syndrome-14. The associations of analgosedation with HRQoL and psychiatric symptoms were investigated by means of multivariable linear regression models. Results The data of 134 ARDS survivors (median age [IQR]: 55 [44–64], 67% men) did not show any significant association between analgosedation and physical or mental HRQoL up to 1 year after ICU discharge. Multivariable linear regression analysis (B [95%-CI]) yielded a significant association between symptoms of psychiatric disorders and increased cumulative doses of ketamine up to 6 months after ICU discharge (after 3 months: depression: 0.15 [0.05, 0.25]; after 6 months: depression: 0.13 [0.03, 0.24] and PTSD: 0.42 [0.04, 0.80)]). Conclusions Up to 1 year after ICU discharge, analgosedation did not influence HRQoL of ARDS survivors. Prolonged administration of ketamine during ICU treatment, however, was positively associated with the risk of psychiatric symptoms. The administration of ketamine to ICU patients with ARDS should be with caution.
UR - https://www.scopus.com/pages/publications/85140417545
U2 - 10.1371/journal.pone.0275743
DO - 10.1371/journal.pone.0275743
M3 - Article
C2 - 36269731
AN - SCOPUS:85140417545
SN - 1932-6203
VL - 17
JO - PLoS ONE
JF - PLoS ONE
IS - 10 October
M1 - e0275743
ER -