Tailored multicomponent program for discomfort reduction in critically ill patients may decrease post-traumatic stress disorder in general ICU survivors at ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-01-30

AUTHORS

Pierre Kalfon, Marine Alessandrini, Mohamed Boucekine, Stéphanie Renoult, Marie-Agnès Geantot, Stéphanie Deparis-Dusautois, Audrey Berric, Olivier Collange, Bernard Floccard, Olivier Mimoz, Amour Julien, René Robert, Juliette Audibert, Anne Renault, Arnaud Follin, Didier Thevenin, Nathalie Revel, Marion Venot, René-Gilles Patrigeon, Thomas Signouret, Mélanie Fromentin, Tarek Sharshar, Coralie Vigne, Julien Pottecher, Quentin Levrat, Achille Sossou, Maïté Garrouste-Orgeas, Jean-Pierre Quenot, Claire Boulle, Elie Azoulay, Karine Baumstarck, Pascal Auquier

ABSTRACT

PurposeReducing discomfort in the intensive care unit (ICU) should have a positive effect on long-term outcomes. This study assessed whether a tailored multicomponent program for discomfort reduction was effective in reducing post-traumatic stress disorder (PTSD) symptoms at 1 year in general ICU survivors. MethodsThis study is a prospective observational comparative effectiveness cohort study involving 30 ICUs. It was an extension of the IPREA3 study, a cluster-randomized controlled trial designed to assess the efficacy of a tailored multicomponent program to reduce discomfort in critically ill patients. The program included assessment of ICU-related self-perceived discomforts, immediate and monthly feedback to the healthcare team, and site-specific tailored interventions. The exposure was the implementation of this program. The eligible patients were exposed versus unexposed general adult ICU survivors. The prevalence of substantial PTSD symptoms at 1 year was assessed based on the Impact of Event Scale–Revised (IES-R).ResultsOf the 1537 ICU survivors included in the study, 475 unexposed patients and 344 exposed patients had follow-up data at 1 year: 57 (12.0%) and 21 (6.1%) presented with PTSD at 1 year, respectively (p = 0.004). Considering the clustering and after adjusting for age, gender, McCabe classification, and ICU-related self-perceived overall discomfort score, exposed patients were significantly less likely than unexposed patients to have substantial PTSD symptoms at 1 year (p = 0.015).ConclusionsImplementation of a tailored multicomponent program in the ICU that has proved to be effective for reducing self-perceived discomfort in general adult ICU survivors also reduced the prevalence of substantial PTSD symptoms at 1 year.Trial registrationClinicalTrials.gov identifier NCT02762409. More... »

PAGES

223-235

Journal

TITLE

Intensive Care Medicine

ISSUE

2

VOLUME

45

Author Affiliations

  • Unité de recherche CEReSS-EA3279, Aix-Marseille Université, Marseille, France
  • Réanimation, Clinique Ambroise Paré, Neuilly/Seine, France
  • Département d’Anesthésie Réanimation, CHU Dijon Bourgogne, Dijon, France
  • Réanimation, CH Troyes, Troyes, France
  • Réanimation polyvalente, Centre Hospitalier Intercommunal Toulon/La Seyne sur mer, Toulon, France
  • Réanimation chirurgicale polyvalente, Hôpital Civil, CHU Strasbourg, Strasbourg, France
  • Réanimation polyvalente, CHU Edouard Herriot, Hospices Civils de Lyon, Lyon, France
  • Réanimation chirurgicale, CHU La Milétrie, Poitiers, France
  • Réanimation de chirurgie cardiaque, CHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
  • Réanimation médicale, CHU La Milétrie, Poitiers, France
  • Réanimation Polyvalente, Hôpital Louis Pasteur, Hôpitaux de Chartres, 28018, Le Coudray, France
  • Réanimation médicale, CHU Brest, Brest, France
  • Réanimation Chirurgicale, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
  • Réanimation, CH Lens, Lens, France
  • Réanimation Médico-Chirurgicale, Hôpital Pasteur, CHU Nice, Nice, France
  • Réanimation Médicale, CHU Saint-Louis, AP-HP, Paris, France
  • Réanimation, CH Auxerre, Auxerre, France
  • Réanimation, Hôpital Européen de Marseille, Marseille, France
  • Réanimation chirurgicale, CHU Cochin, AP-HP, Paris, France
  • Réanimation médicale adulte, CHU Raymond Poincaré, AP-HP, Paris, France
  • Réanimation chirurgicale, CHU Hôpital Nord, Assistance Publique–Hôpitaux de Marseille, Marseille, France
  • Réanimation chirurgicale, Hôpital Hautepierre, CHU Strasbourg, Strasbourg, France
  • Groupe Hospitalier de La Rochelle-Ré-Aunis, La Rochelle, France
  • Réanimation, CH Émile Roux, Le Puy-En-Velay, France
  • Médecine intensive et réanimation, Groupe Hospitalier Paris Saint-Joseph, Paris, France
  • Réanimation médicale, CHU Dijon Bourgogne, Dijon, France
  • Réanimation, CH Douai, Douai, France
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00134-018-05511-y

    DOI

    http://dx.doi.org/10.1007/s00134-018-05511-y

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1111774254

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30701294


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