Study | Time point | Outcome measured | Results |
Bugedo et al18 | 1-year postdischarge | Screening for memories via telephone interview. Post-Traumatic Stress Syndrome-10 (PTSS-10) Scale | No difference in incidence of nightmares (n=22 (55%) vs 15 (43), p=0.294), severe anxiety or panic (n=16 (40%) vs 12 (34), p=0.610) or pain (n=12 (30%) vs 13 (37), p=0.513, feelings of suffocation or PTSS-10 (28 (19–3(sic)) vs 26 (17–38), p=0.840) questionnaire scores between the deep and light sedation groups. |
Burry et al41 (substudy of Mehta et al23) | 28 days post-ICU discharge | ICU Memory Tool | Patients who reported ‘not remembering the ICU’ had less sedation (average daily midazolam dose 26.9 (SD 63.7) vs 82.5 (SD 314) mg), but no difference in SAS scores (3.34 (SD 0.70) vs 3.27 (0.65)). In a multivariate model, total midazolam (OR 1.182, 95% CI 0.37 to 3.81) and fentanyl (OR 2.27, 95% CI 0.64 to 8.14) exposure above the mean (deeper sedation) were not associated with increased risk of delusional memories. |
Capuzzo et al36 | 6 months posthospital discharge | Memories explored through semi-structured interviewed, then retrospectively categorised | No significant difference in recall of factual (A (no morphine/minimal sedatives): n=16 (36); B (morphine only): 29 (34); C (morphine and sedatives): 4 (18)), sensation (A: n=4 (9); B: 13 (15); C: 3 (14)) or emotional (A: n=4 (9); B: 6 (7); C: 4 (18)) memories of ICU between the groups. |
Costa et al40 | Approximately 3 days post-ICU discharge | Locally adapted ICU Memory Tool Not specified how anxiety, depression or PTSD were measured | No difference in the incidence of anxiety, depression or PTSD across mild-to-moderate, deep or not sedation groups. Patients who received any level of sedation reported less real memories (21 (24%) vs 29 (69%)), more real and illusory memories (42 (49%) vs 9 (21)), more illusory memories (7 (8%) vs 0) and more amnesia (16 (19%) vs 4 (10)) than patients who received no sedation (p<0.001). |
Nassar Junior, Park M et al24 | 6 months post-ICU discharge | Impact of Events Scale (IES) | No difference in the level of psychological stress on the IES (22 (8–31) vs 16 (4–34), p=0.750) between intermittent sedation or daily interruption of sedation groups. |
Samuelson 200637 | 3–5 days post-ICU discharge | ICU Memory Tool | Deep sedation was associated with amnesia (OR 1.60, 95% CI 1.35 to 1.91) and delusional memories (OR 1.76, 95% CI 1.14 to 2.72) on multivariate analysis. |
Samuelson et al38 | 3–5 days post-ICU discharge | ICU Memory Tool Locally adapted ICU Stressful Experiences Questionnaire | Patients with memory of ETT had higher proportion of MAAS 3 (awake) than those with no memory (0.56 (0.42) vs 0.18 (0.4), p<0.0001)—this relationship was confirmed on multivariate analysis (OR 1.45, 95% CI 1.29 to 1.62). Similarly, patients with a higher proportion of MAAS 3 were more likely to be bothered by memories of stressful experiences of ICU (OR 1.37, 95% CI 1.13 to 1.67). |
Samuelson et al27 | 3–5 days post-ICU discharge and 2 months | ICU Memory Tool Locally adapted ICU Stressful Experiences Questionnaire IES-Revised (IES-R) | No difference in memories of ICU (n=15 (88%) vs 17 (94), p=0.60), presence of delusional memories in ICU (n=1 (6%) vs 6 (33), p=0.09) or memories of pain (n=4 (23%) vs 9 (50), p=0.20) between the groups. |
Strom et al42 | 2 years post-randomisation | ICU Memory Tool SF-36, Beck Depression Index (BDI), IES, State Anxiety Inventory, PTSD Symptoms (PTSS)-10 | No difference in psychological problems postdischarge (n=2 (15%) vs 6 (46), p=0.20), PTSS-10 score >35 (n=1 (8%) vs 0 (0), p=0.14) or any of the other psychological health outcomes between the no sedation and sedation groups. |
Treggiari et al30 | At discharge and 4 weeks post-ICU discharge | PTSD Checklist IES-R Hospital Anxiety and Depression Scale | No difference in PTSD questionnaire score (discharge: 57±30 vs 52±33, p=0.39; 4-week follow-up: 56±29 vs 46±29, p=0.07), PTSD symptom clusters, anxiety or depression (discharge: 6.5±4.7 vs 5.3±3.4, p=0.13; 4-week follow-up: 3.1±3.7 vs 3.4±3.7, p=0.72) scores or cases at either discharge or 4-week follow-up between the groups. |
PTSD, post-traumatic stress disorder.