Frightening and Traumatic Memories Early after Intensive Care Discharge

Train, Sarah; Kydonaki, Kalliopi; Rattray, Janice; Stephen, Jacqueline; Weir, Christopher J.; Walsh, Timothy

doi:10.1164/rccm.201804-0699le

Cited by 13 publications

(11 citation statements)

References 12 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The SARS-CoV-2 pandemic has shown us that this is especially true for those patients requiring sedation and long-term mechanical ventilation [ 26 , 27 ]. From the patient’s perspective, evaluating the impact of these memories is important, as early stressful and frightening memories might contribute to long-term psychological morbidity after ICU [ 9 ]. Moreover, the large cohort of post ICU patients that the COVID-19 pandemic created, and continues to create, requires structured follow-ups and the availability of further rehabilitation interventions [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…The existence of stressful and potentially traumatic memories may contribute to substantial psychological distress and lead to the development of long-term psychological morbidity such as posttraumatic stress disorder (PTSD), anxiety or depression [ 5 , 6 , 7 ]. Previous studies have shown that the number of stressful events remembered is important [ 8 , 9 ]. However, the magnitude of distress intensity is of the greatest significance, i.e., the imprint of one traumatic experience can be sufficient to cause substantial subsequent distress [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Stressful Memory Assessment Checklist for the Intensive Care Unit (SMAC-ICU): Development and Testing

Samuelson

2022

Healthcare

View full text Add to dashboard Cite

Stressful or traumatic memories of an intensive care stay may lead to long-term psychological morbidity. Memory assessment is therefore essential to aid in the patients’ recovery process. Acknowledging the large cohort of post ICU patients during the SARS-CoV-2 pandemic, a simple tool for the evaluation of ICU memories is needed. The aim of this study was, therefore, to develop and test the validity and reliability of a short stressful memory assessment checklist, including a distress intensity rating scale, for intensive care survivors. The consecutive sample consisted of 309 patients attending an intensive care follow-up consultation in Sweden. A methodological design was used consisting of four phases. The first three concerned construct and content validity and resulted in a 15-item checklist of potential stressful memories with a Likert-type scale including five response categories for distress intensity rating. To fill out the checklist, a median of 3 (2–3) minutes was needed. A test–retest approach yielded weighted kappa values between 0.419 and 0.821 for 12 of the single items and just below 0.4 for the remaining three. In conclusion, the stressful memory assessment checklist seems to be valid and reliable and can be used as a simple tool to evaluate the impact of stressful ICU memories.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Stressful Memory Assessment Checklist for the Intensive Care Unit (SMAC-ICU): Development and Testing

Samuelson

2022

Healthcare

View full text Add to dashboard Cite

show abstract

“…There was, however, inconsistent evidence of whether, and how, sedation depth might influence the presence and type of memories (18,27,(36)(37)(38)40,41). The role of memories after critical illness, and the relationship with psychological health, is inconsistent, with some suggestion that intrusive, persecutory or delusional memories may be more harmful than real memories (43), with the possibility that more frightening memories might be associated with greater psychological trauma (44). No evidence of a relationship between sedation depth and delirium was identified in this review, however any potential relationship between sedation, delirium and memories requires further investigation (43).…”

Section: Discussionmentioning

confidence: 99%

Inconsistent relationship between depth of sedation and intensive care outcome: systematic review and meta-analysis

Aitken

Kydonaki

Blackwood

et al. 2021

Thorax

Self Cite

View full text Add to dashboard Cite

PurposeTo determine the effect of depth of sedation on intensive care mortality, duration of mechanical ventilation, and other clinically important outcomes.MethodsWe searched MEDLINE, Embase, Cochrane Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO from 2000 to 2020. Randomised controlled trials (RCTs) and cohort studies that examined the effect of sedation depth were included. Two reviewers independently screened, selected articles, extracted data and appraised quality. Data on study design, population, setting, patient characteristics, study interventions, depth of sedation and relevant outcomes were extracted. Quality was assessed using Critical Appraisal Skills Programme tools.ResultsWe included data from 26 studies (n=7865 patients): 8 RCTs and 18 cohort studies. Heterogeneity of studies was substantial. There was no significant effect of lighter sedation on intensive care mortality. Lighter sedation did not affect duration of mechanical ventilation in RCTs (mean difference (MD): −1.44 days (95% CI −3.79 to 0.91)) but did in cohort studies (MD: −1.52 days (95% CI −2.71 to −0.34)). No statistically significant benefit of lighter sedation was identified in RCTs. In cohort studies, lighter sedation improved time to extubation, intensive care and hospital length of stay and ventilator-associated pneumonia. We found no significant effects for hospital mortality, delirium or adverse events.ConclusionEvidence of benefit from lighter sedation is limited, with inconsistency between observational and randomised studies. Positive effects were mainly limited to low quality evidence from observational studies, which could be attributable to bias and confounding factors.

show abstract

“…[1][2][3][4] While its long-term psychological impact on survivors is not yet known, prior data suggest ICU survivors often have upsetting memories of the ICU experience (e.g., fears of death, breathing discomfort, hallucinations during delirium) that may precede new or worsening mental health problems. 5,6 Few studies have examined the early phase of post-ICU recovery, 7 including peritraumatic stress symptoms that can occur during or in the immediate aftermath of a traumatic experience. These symptoms, such as feeling emotionally numb or disconnected from reality, are linked to later PTSD onset in other populations, [8][9][10] suggesting they may be harbingers of future PTSD.…”

mentioning

confidence: 99%

“…The coronavirus disease (COVID-19) pandemic has already left many intensive care unit (ICU) survivors in its wake ( 1 – 4 ). Although its long-term psychological impact on survivors is not yet known, prior data suggest ICU survivors often have upsetting memories of the ICU experience (e.g., fears of death, breathing discomfort, hallucinations during delirium) that may precede new or worsening mental health problems ( 5 , 6 ). Few studies have examined the early phase of post-ICU recovery ( 7 ), including peritraumatic stress symptoms that can occur during or in the immediate aftermath of a traumatic experience.…”

mentioning

confidence: 99%