Post-Traumatic Stress Disorder after Weaning from Prolonged Mechanical Ventilation

Amal Jubran, Gerald Lawm, Lisa A. Duffner, Eileen G. Collins, Dorothy M. Lanuza, Leslie A. Hoffman, Martin J. Tobin

Intensive Care Med (2010) 36:2030–2037

Purpose: Weaning from prolonged mechanical ventilation may be associated with mental discomfort. It is not known whether such discomfort is linked with the development of post-traumatic stress disorder (PTSD). Accordingly, we investigated whether PTSD occurs in patients after weaning from prolonged ventilation. We also determined whether administering a questionnaire would identify patients at risk for developing PTSD.

Methods: A prospective longitudinal study of patients transferred to a longterm acute-care hospital for weaning from prolonged ventilation was undertaken: 72 patients were studied 1 week after weaning, and 41 patients were studied again 3 months later. An experienced psychologist conducted a structured clinical interview 3 months after weaning to establish a diagnosis of PTSD. To assess for the presence of PTSD-related symptoms, the posttraumatic stress syndrome (PTSS-10) questionnaire was administered 1 week after weaning and 3 months later.

Results: The psychologist diagnosed PTSD in 12% of patients 3 months after ventilator weaning. Patients who developed PTSD were more likely to have a previous history of psychiatric disorders (P20 one week after weaning reliably identified patients who were diagnosed with PTSD 3 months later: sensitivity 1.0; specificity 0.76; area under the receiveroperating characteristic curve 0.91.

Conclusion: PTSD was diagnosed in 12% of patients who were weaned from prolonged ventilation. A PTSS-10 score >20 one week after weaning identified patients diagnosed with PTSD 3 months later. This finding suggests that a simple questionnaire administered before hospital discharge can identify patients at risk for developing PTSD.

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