Post-traumatic stress symptoms in Guillain-Barré syndrome patients after prolonged mechanical ventilation in ICU: a preliminary report.
Thirty percent of Guillain-Barré syndrome (GBS) patients require mechanical ventilation (MV) in intensive care unit (ICU). Post-traumatic stress disorder (PTSD) is found in ICU survivors, and the traumatic aspects of intubation and MV have been previously reported as risk factors for PTSD after ICU. Our objective was to determine long-term PTSD or post-traumatic stress symptoms (PTSS) in GBS patients after prolonged MV in ICU. We assessed GBS patients who had MV for more than 2 months. PTSD was assessed using Horowitz Impact of Event Scale (IES), IES-Revisited (IES-R), and the Post-traumatic CheckList Scale; functional outcome using Rankin and Barthel scales; quality of life (QoL) using Nottingham Health Profile (NHP) and 36-Item Short Form Health Survey (SF-36) and depression using Hospital Anxiety and Depression Scale (HAD) and Beck questionnaire. Thirteen patients could be identified and analyzed. They had only mild disability. They were neither anxious nor depressed with an anxiety HAD at 5 (4-11.5), a depression HAD at 1 (0-3.5) and a Beck at 1 (0-5). QoL was mildly decreased in our population with a NHP at 78.5 (12.8-178.8) and mild decreased SF-36. Compared with the French population, the SF-36 sub-categories were, however, not statistically different. Twenty-two percentage of our 13 patients had PTSD and PTSS with a Horowitz IES at 12 (2-29), and an IES-R at 16 (2-34.5). Although severe GBS patients requiring prolonged MV had good functional recovery and no difference in QoL, they had a high incidence of PTSS.
Unité de Réanimation Neurologique, Neurologie 1, Pôle des Maladies du Système Nerveux, Paris, France; Institut Hospitalo-Universitaire-A-Institut du Cerveau et de la Moelle, Paris, France.
Loïc
L
Le Guennec
Marion
M
Brisset
Karine
K
Viala
Fatiha
F
Essardy
Thierry
T
Maisonobe
Benjamin
B
Rohaut
Sophie
S
Demeret
Francis
F
Bolgert
Nicolas
N
Weiss
D000328:Adult; D000368:Aged; D005260:Female; D020275:Guillain-Barre Syndrome / Q000523:psychology* / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012042:Registries; D012121:Respiration, Artificial / Q000523:psychology*; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome
Guillain-Barre syndrome; mechanical ventilation; outcome; post-traumatic stress disorder; post-traumatic stress symptoms; quality of life