Intensive care unit drug use and subsequent quality of life in acute lung injury patients.
OBJECTIVE
To examine the relationship between the use of sedative and neuromuscular blocking agents during a patient's intensive care unit (ICU) stay and subsequent measures of health-related quality of life.


METHODS
Cross-sectional mail survey and retrospective medical record abstraction of a prospectively identified cohort of lung injury patients.


METHODS
ICUs in three teaching hospitals in a major metropolitan area.


METHODS
Patients with acute lung injury (n = 24).


METHODS
None--observational study.


RESULTS
Patients' charts were reviewed for those patients returning postdischarge quality-of-life questionnaires. Duration, daily dose, and route of administration for sedatives and neuromuscular blocking agents were abstracted from ICU flow sheets. Relationships among ICU variables (days of sedation, days of neuromuscular blockade, and severity of illness as measured by Acute Physiology and Chronic Health Evaluation III score) and outcomes (symptoms of depression and symptoms of posttraumatic stress disorder) were assessed. Depressive symptoms at follow-up were correlated with days of sedation (p = .007), but not with days of neuromuscular blockade or initial severity of illness. The composite posttraumatic stress disorder symptom impact score was correlated with days of sedation (p = .006) and days of neuromuscular blockade (p = .035), but not with initial severity of illness. There were no significant differences between the frequency of patients reporting a specific posttraumatic stress disorder symptom in the high sedation group and the low sedation group, and there were no significant differences in specific posttraumatic stress disorder symptoms between the group that had received neuromuscular blockade and those who had not.


CONCLUSIONS
The use of sedatives and neuromuscular blocking agents in the ICU is positively associated with subsequent measures of depression and posttraumatic stress disorder symptoms 6-41 months after ICU treatment for acute lung injury.
Nelson
B J
BJ
Hennepin County Medical Center, Minneapolis, MN, USA.
Weinert
C R
CR
Bury
C L
CL
Marinelli
W A
WA
Gross
C R
CR
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D003422:Critical Care / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage / Q000009:adverse effects*; D011788:Quality of Life; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000523:psychology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology
D006993:Hypnotics and Sedatives; D009466:Neuromuscular Blocking Agents