Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement

American Journal of Respiratory and Critical Care Medicine, Journal Year: 2023, Volume and Issue: 207(7), P. e49 - e68

Published: March 31, 2023

Section:ChooseTop of pageAbstract <

Language: Английский

---

Intensive care unit interventions to promote sleep and circadian biology in reducing incident delirium: a scoping review

Thorax, Journal Year: 2024, Volume and Issue: 79(10), P. 988 - 997

Published: Feb. 13, 2024

Despite plausible pathophysiological mechanisms, research is needed to confirm the relationship between sleep, circadian rhythm and delirium in patients admitted intensive care unit (ICU). The objective of this review summarise existing studies promoting, whole or part, normalisation sleep biology their impact on incidence, prevalence, duration and/or severity ICU.

Language: Английский

---

Phenotypes and subphenotypes of delirium: a review of current categorisations and suggestions for progression

Critical Care, Journal Year: 2021, Volume and Issue: 25(1)

Published: Sept. 15, 2021

Abstract Delirium is a clinical syndrome occurring in heterogeneous patient populations. It affects 45–87% of critical care patients and often associated with adverse outcomes including acquired dementia, institutionalisation, death. Despite an exponential increase delirium research recent years, the pathophysiological mechanisms resulting presentation are still hypotheses. Efforts have been made to categorise spectrum into clinically meaningful subgroups (subphenotypes), using psychomotor subtypes such as hypoactive, hyperactive, mixed, for example, also inflammatory non-inflammatory delirium. remains, however, constellation symptoms from variety risk factors precipitants currently no successful targeted pharmacological treatment. Identifying specific biological subphenotypes will greatly improve understanding relationship between putative pathways thus factors, precipitants, natural history, mechanism. This facilitate factor mitigation, identification potential methods interventional studies, informed family counselling. Here, we review evidence date propose framework identify subphenotypes. Endotype may be done by clustering their mechanism, which treatments. In order achieve subphenotypes, following steps must taken: (1) robust records kept at level. (2) Global collaboration large, cohorts. (3) Patients clustered identification, validation, mapping subphenotype stability.

Language: Английский

---

Effect of earplug/eye mask on sleep and delirium in intensive care patients

Nursing in Critical Care, Journal Year: 2022, Volume and Issue: 27(4), P. 537 - 545

Published: Jan. 12, 2022

Abstract Background Environmental factors such as loud sounds and bright lights in intensive care units can cause sleep disorders delirium. Aim The present study aims to investigate the effects of overnight use earplugs eye masks by patients on their quality degree Study Design This randomized controlled experimental was conducted admitted a coronary unit. Methods group used during night, while those control received only routine care. Data were collected using an information form, Richards‐Campbell questionnaire (RCSQ), delirium screening checklist (ICDSC). Results included total 84 patients, 42 group. baseline average score experiment RCSQ 40.11 ± 16.55, with Time 1 64.09 14.07 2 72.07 11.75; ICDSC 0.47 0.50, 0.33 065 0.19 039. 44.07 7.30, 46.97 9.22 47.04 11.53; 0.42 0.50 0.70 0.57 0.66. A statistically significant difference found between scores groups (U = 198.00, P < .001; U 70.000, 614.000, ·004 respectively). Conclusions associated increase decrease Relevance Clinical Practice is recommended for supporting preventing

Language: Английский

---

Cuidados independientes que realizan los profesionales de enfermería en la prevención del delirio

Interdisciplinary Rehabilitation / Rehabilitacion Interdisciplinaria, Journal Year: 2023, Volume and Issue: 3, P. 55 - 55

Published: Aug. 21, 2023

Introduction: Delirium is a condition that affects attention, consciousness, and cognition, especially in older people. It can result from underlying diseases or medications. has great economic social impact, with the need for special care, increased risk of falls, prolonged hospitalization institutionalization. Methods: A literature search was performed SciELO Scopus keywords "delirium", "prevention" "nursing" establishing inclusion exclusion criteria to select 15 relevant articles on independent care provided by nursing professionals prevention delirium occurrence last 5 years open access. Results: The importance management through interventions use specific tools highlighted. potential technology early detection preventive intervention Nurses play an essential role identification implementing various assessment tools. implementation standardized measures protocols improve quality recommended, although future studies suggested. Conclusion: observed, highlighting their effectiveness reducing incidence severity. usefulness easily accessible technologies On other hand, continuous research patient life emphasized.

Language: Английский

---

Sleep assessment in critically ill adults: A systematic review and meta-analysis

Journal of Critical Care, Journal Year: 2022, Volume and Issue: 71, P. 154102 - 154102

Published: July 15, 2022

Language: Английский

---

Nonpharmacological interventions to promote sleep in the adult critical patients unit: A scoping review

Australian Critical Care, Journal Year: 2025, Volume and Issue: 38(3), P. 101159 - 101159

Published: Jan. 16, 2025

Sleep and circadian rhythms are markedly altered in intensive care unit (ICU) patients. Numerous factors related to the patient ICU environment affect ability initiate maintain sleep. Therefore, nonpharmacological interventions could play an essential role improving sleep rhythm. The aim of this study was examine evaluated for promoting adult ICUs. A scoping review conducted, including randomised controlled trials, nonrandomised quasi-experimental other studies investigating effects total 57 articles 14 ongoing trials were included review, which 38 clinical trials. Nine improve critically ill patients evaluated: earplugs and/or eye masks, aromatherapy, bundles, music intervention, massage or acupressure, noise masking, bright light, dynamic light. Most simultaneously assessed effect more than one intervention on perceived quality using questionnaires. association between improved varied. In case multicomponent interventions, it is difficult identify components might have influenced improvement. various promote patients, several quality. However, substantial variability their implementation complicates drawing reliable conclusions. protocol registered with Open Science Framework under identifier https://doi.org/10.17605/OSF.IO/MPEQ5.

Language: Английский

---

Relationship between inflammatory factors, lactic acid levels, acute skin failure, bad mood, and sleep quality

World Journal of Psychiatry, Journal Year: 2025, Volume and Issue: 15(4)

Published: March 25, 2025

The central link between septic shock and acute skin failure (ASF) is the inflammatory response, which occurs throughout disease progression can lead to systemic response syndrome. Patients often experience bad moods, sleep disorders, other health issues. Despite recognizing these factors, no studies have examined correlation lactic acid levels, ASF, mood disturbances, quality in critically ill patients. We hypothesize that higher levels of factors are associated with more severe ASF poorer quality, may inform clinical treatment for ASF. To explore relationship severity mood, quality. retrospective study included 150 patients from Second Hospital Dalian Medical University, categorized into (n = 35) or non-ASF groups 115). compared peripheral blood including tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6), mottling score (SMS), modified early warning (MEWS), self-rating depression scale (SDS), anxiety (SAS), Pittsburgh index (PSQI) scores. Pearson analysis assessed relationships among variables. group had significantly CRP (19.60 ± 4.10 vs 15.30 2.96 mg/mL), IL-6 (298.65 48.65 268.66 33.66 pg/L), procalcitonin, (8.42 2.32 5.70 1.27 mmol/L), SMS [0 (0, 1) 3 (2, 3)], MEWS (9.34 1.92 6.48 1.96), SAS (61.63 12.03 53.71 12.48), SDS (60.17 12.64 52.27 12.64), PSQI scores (14.23 3.94 8.69 2.46) (all P < 0.001). revealed IL-6, CRP, TNF-α, were positively correlated SMS, MEWS, SAS, SDS, (P 0.05). Peripheral correlate

Language: Английский

---

‘Transauricular vagus nerve stimulation’ for prevention of postoperative delirium in elderly patients undergoing major surgery: a study protocol for a multicentre, participant-blinded and assessor-blinded, randomised, controlled trial

BMJ Open, Journal Year: 2025, Volume and Issue: 15(4), P. e093647 - e093647

Published: April 1, 2025

Introduction Postoperative delirium (POD) is a frequent complication in elderly patients undergoing major surgery. Research has shown that neuroinflammation, postoperative pain and autonomic nervous system dysfunction play significant roles its onset. Vagus nerve stimulation (VNS) the potential to reduce inflammation, ease aid recovery by enhancing acetylcholine release activating cholinergic anti-inflammatory pathway. This study aims assess effectiveness safety of transauricular VNS (ta-VNS) preventing POD Methods analysis multicentre, participant-blinded assessor-blinded, randomised, parallel-group controlled trial will compare incidence surgery who receive ta-VNS versus sham stimulation. A total 300 eligible be randomly assigned 1:1 ratio either active or group. The group electrical left cymba conchae at frequency 30 Hz pulse width 250 µs, with s on/30 off cycle. intensity start 0.4V increased increments until tingling sensation felt, then adjusted highest tolerable level without pain. After obtaining informed consent randomisation, initial intervention begin preoperative area continue throughout For four days, administered twice daily 2-hour sessions each morning afternoon. follow same procedure, electrodes placed on conchae. adjusting intensity, device switched off. primary outcome from day 0 7 discharge. Secondary outcomes include severity POD, quality recovery, sleep adverse events. Ethics dissemination protocol was approved Sir Run Shaw Hospital Affiliated Zhejiang University School Medicine 9 January 2024 (Approval number: 20240014), registered Chinese Clinical Trial Registry 21 February 2024, prior recruitment. performed according guidelines Declaration Helsinki. Written obtained all participants. results submitted for publication refereed journal. registration number ChiCTR2400081078.

Language: Английский

---

Association between admission Braden Skin Score and delirium in surgical intensive care patients: an analysis of the MIMIC-IV database

Frontiers in Neurology, Journal Year: 2025, Volume and Issue: 16

Published: April 14, 2025

Background The Braden Skin Score (BSS), a tool for assessing pressure ulcers, is increasingly recognized its prognostic value in various disorders. However, link to critical delirium surgical patients remains understudied. This study aimed explore the association between BSS upon admission and risk of SICU patients. Methods retrospective observational cohort used data from Medical Information Mart Intensive Care (MIMIC)-IV database. primary outcome was incidence delirium. Feature importance initially assessed using machine learning algorithm, while restricted cubic spline (RCS) models multivariable logistic analysis evaluated relationship Additionally, Kaplan–Meier mediation were conducted interactions among BSS, delirium, short-term mortality. Results A total 4,899 included study, whom 1,491 diagnosed with Boruta algorithm identified as significant predictor occurrence. RCS demonstrated non-linear positive Based on curves, optimal threshold established at 16, thereby categorizing participants into two groups: those &lt; 16 ≥ 16. Multivariable regression revealed that lower positively correlated an increased These findings exhibited robust consistency across subgroup analyses sensitivity analyses. Furthermore, groups had higher 90-day mortality, mediating indirect effect this outcome. Conclusion low independently associated critically ill Patients exhibiting below heightened susceptibility onset necessitating vigilant monitoring timely intervention. Larger prospective studies are needed confirm these findings.

Language: Английский

---