A multicentre point prevalence study of nocturnal hours awake and enteral pharmacological sleep aids in patients admitted to Australian and New Zealand intensive care units

被引：3
作者：
Showler, Laurie [1 ,2 ]
Deane, Adam M. [1 ,2 ]
Litton, Edward [3 ,4 ]
Ankravs, Melissa J. [1 ,2 ,5 ]
Wibrow, Bradley [3 ,6 ]
Barge, Deborah [1 ,2 ]
Goldin, Jeremy [1 ,7 ]
Hammond, Naomi [8 ,9 ]
Saxena, Manoj K. [9 ,10 ]
Young, Paul J. [9 ,11 ,12 ,13 ]
Venkatesh, Bala [9 ,14 ,15 ,16 ,17 ]
Finnis, Mark [1 ,18 ,19 ]
Abdelhamid, Yasmine Ali [1 ,2 ]
机构：
[1] Univ Melbourne, Melbourne Med Sch, Dept Crit Care, Melbourne, Vic, Australia
[2] Royal Melbourne Hosp, Dept Intens Care, Melbourne, Vic, Australia
[3] Univ Western Australia, Perth, WA, Australia
[4] Fiona Stanley Hosp, Dept Intens Care, Murdoch, WA, Australia
[5] Royal Melbourne Hosp, Dept Pharm, Melbourne, Vic, Australia
[6] Sir Charles Gairdner Hosp, Dept Intens Care, Nedlands, WA, Australia
[7] Royal Melbourne Hosp, Dept Resp & Sleep Med, Melbourne, Vic, Australia
[8] Royal North Shore Hosp, Malcolm Fisher Dept Intens Care, St Leonards, NSW, Australia
[9] UNSW Sydney, George Inst Global Hlth, Crit Care Program, Barangaroo, NSW, Australia
[10] St George Hosp, Dept Intens Care, Kogarah, NSW, Australia
[11] Wellington Hosp, Dept Intens Care, Wellington, New Zealand
[12] Med Res Inst New Zealand, Wellington, New Zealand
[13] Monash Univ, Australian & New Zealand Intens Care Res Ctr, Melbourne, Vic, Australia
[14] Princess Alexander Hosp, Dept Intens Care, Woolloongabba, Qld, Australia
[15] Wesley Hosp, Dept Intens Care, Auchenflower, Qld, Australia
[16] Univ Queensland, Brisbane, Qld, Australia
[17] Univ New South Wales, Kennington, NSW, Australia
[18] Univ Adelaide, Adelaide, SA, Australia
[19] Royal Adelaide Hosp, Dept Intens Care, Adelaide, SA, Australia
来源：
CRITICAL CARE AND RESUSCITATION | 2024年 / 26卷 / 03期
关键词：
Critical illness; Hypnotics and sedatives; Melatonin; Sleep; Sleep-wake disorders; ICU; DISRUPTION; DELIRIUM; QUALITY;
D O I：
10.1016/j.ccrj.2024.06.009
中图分类号：
R4 [临床医学];
学科分类号：
1002 ; 100602 ;
摘要：
Objective: Critically ill patients suffer disrupted sleep. Hypnotic medications may improve sleep; however, local epidemiological data regarding the amount of nocturnal time awake and the use of such medications is needed. Design: Point prevalence study. Setting: Adult ICUs in Australia and New Zealand. Participants: All adult patients admitted to participating Intensive Care Units (ICUs) on the study day. Main outcome measures: Time awake overnight (22:00-06:00) was determined by structured nurse observation. The use of enterally administered sedative-hypnotic drugs prior to and during ICU admission was recorded, as was the use of a unit policy and non-pharmacological sleep promotion strategies. Results: Data were available for 532 patients admitted to 40 ICUs (median age 60 years, 336 (63.2%) male, and 222 (41.7%) invasively ventilated). Forty-eight patients (9.0%) received an enteral pharmacological sleep aid, of which melatonin (28, 5.2%) was most frequently used. Patients not invasively ventilated were observed to be awake overnight for a median of 4.0 h (interquartile range (IQR): 2.5, 5.5), with no difference in those receiving an enteral hypnotic (p = 0.9). Non-pharmacological sleep aids were reportedly not offered or available for 52% (earplugs) and 63% of patients (eye masks). Only 7 (17.5%) participating ICUs had a policy informing sleep-optimising interventions. Conclusions: Patients not receiving invasive ventilation appeared to spend many nocturnal hours awake. Pharmacological sleep aid administration was not associated with a greater observed time asleep. Most patients did not receive any non-pharmacological aid, and most ICUs did not have a local guideline or unit policy on sleep promotion. (c) 2024 The Authors. Published by Elsevier B.V. on behalf of College of Intensive Care Medicine of Australia and New Zealand. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
引用
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页码：192 / 197
页数：6
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