MedicalResearch.com Interview with:
Jad Kebbe, MD
Jacobs School of Medicine and Biomedical Sciences
Department of Medicine
University of Buffalo
Medical Research: What is the background for this study? What are the main findings?
Dr. Kebbe: This study proceeded after sensing that post-traumatic stress disorder (PTSD) was a major contributor to ill outcomes in Veterans who are hospitalized in general, and mechanically ventilated in the intensive care unit (ICU) in particular. There is plenty of data depicting the comorbid roles PTSD plays in other medical conditions, leading to an increase in the use of medical services. Furthermore, PTSD affects a Veteran’s adherence to both medical and psychiatric therapies. Having said this, the ICU course could itself negatively affect a pre-existing PTSD, or even lead to the inception of such a condition de novo. However, to date, there has been no study looking at the effect a pre-existing PTSD diagnosis may have on the ICU hospitalization and thereafter.
Our study confirmed that PTSD led to an increase in sedative requirements (opiates and benzodiazepines) for Veterans who were mechanically ventilated for more than 24h between 2003 and 2013, and revealed a trend towards an increase in mortality when compared to Veterans not suffering from PTSD.
Medical Research: What should clinicians and patients take away from your report?
Dr. Kebbe: PTSD affects Veterans’ health and healthcare in a plethora of ways. The ICU hospitalization is an experience associated with a particular degree of vulnerability. Proper attention to the sedation regimens in mechanically ventilated critically ill patients, while taking into account the PTSD component of their comorbidities, could be a key to better clinical outcomes.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Kebbe: Larger studies with longer followup may lead to a better understanding of this interaction, with a proper awareness of the PTSD component. Since more than 10% of ICU patients at our Veterans Administration Medical Center suffer from PTSD, this cannot be overemphasized.
- Schnurr P, Friedman M, Sengupta A, Jankowski MK, Holmes T. PTSD and Utilization of Medical Treatment Services among Male Vietnam Veterans. J Nerv Ment Dis. 2000 Aug;188(8):496-504.
- Spoont M, Sayer N, Nelson DB. PTSD and Treatment Adherence: the role of health beliefs. J Nerv Ment Dis. 2005 Aug;193(8):515-22.
Abstract to be presented at the upcoming CHEST 2015:
Veterans with PTSD admitted to the ICU found to have higher sedation requirements
Jad Kebbe, MD (2015). Veterans with PTSD Require More Sedatives in Critical Care Units MedicalResearch.com