Sleep in the intensive and intermediate care units: Exploring related factors of delirium, benzodiazepine use and mortality

Intensive and Critical Care Nursing, Journal Year: 2024, Volume and Issue: 81, P. 103603 - 103603

Published: Jan. 3, 2024

The primary purpose was to examine sleep difficulties and delirium in the Intensive Intermediate Care Unit. Secondarily, factors impacting night-time duration quality, mortality, impact of benzodiazepine use on outcomes were investigated. This retrospective study encompassed data from 323 intensive intermediate care unit admissions collected Netherlands, spanning November 2018 May 2020. Sleep quality measured using Richards-Campbell Questionnaire. Night-time nurse-reported. We investigated associations these with age, sex, length-of-stay, natural daylight, disease severity, mechanical ventilation, use, Generalized Estimating Equations models. Associations one-year post-discharge mortality analyzed Cox regression. short (median 4.5 hours) poor (mean score 4.9/10). Benzodiazepine common (24 % included nights) negatively associated (B = -0.558 -0.533, p <.001). Delirium overnight transfers -0.716 −1.831, <.05). day-to-night ratio higher three days before onset than non-delirious individuals (p Age, severity female sex increased mortality. negatively, but not-significantly, =.070). critical environment has a quality. not improved sleep. patterns change ahead onset. Consistent monitoring should be part routine nursing practice, validated instrument like Given lack proven efficacy benzodiazepines promoting settings, it is vital develop more effective treatments that include non-benzodiazepine medication hygiene strategies.

Language: Английский

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Different nursing interventions on sleep quality among critically ill patients: A systematic review and network meta-analysis

Medicine, Journal Year: 2023, Volume and Issue: 102(52), P. e36298 - e36298

Published: Dec. 29, 2023

Critically ill patients in intensive care often struggle with disrupted sleep, a prevalent issue this population. However, the question of which non-pharmacological intervention is most effective enhancing sleep quality remains unanswered. This study was conducted to comprehensively evaluate and compare efficacy various interventions aimed at improving among critically individuals.

Language: Английский

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Effect of inhaled aromatherapy on sleep quality in critically ill patients: A systematic review and network meta‐analysis

Journal of Clinical Nursing, Journal Year: 2024, Volume and Issue: unknown

Published: July 23, 2024

Abstract Aim This study aimed to compare the effect of inhaled aromatherapy using various essential oils on sleep quality critically ill patients. Background Inhalation significantly promotes physiological and psychological health patients in intensive care units (ICUs). However, research identifying ranking effects different is lacking. Design followed PRISMA Extension Statement for Reporting Systematic Reviews Incorporating Network Meta‐Analyses Health Care Interventions (PRISMA‐NMA) guidelines. Methods A comprehensive search five databases (Embase, MEDLINE, Cochrane Library, CINAHL PsycINFO) was conducted from their inception March 15, 2023 (with an additional eligible included dated August 14, 2023). Google Scholar used as a supplementary method. Frequentist NMA determine oils. Certainty evidence (CoE) assessed Confidence Meta‐Analysis (CINeMA). Results total 11 trials involving 690 were analysis. The revealed that combination lavender, Matricaria recutita , neroli (ratio 6:2:0.5) resulted most significant improvement compared usual care, by Rosa damascene peppermint, Citrus aurantium pure sunflower oil lavender alone. overall CoE results rated low. Conclusions this indicate positively affected among Despite low evidence, non‐invasive easy use. Relevance Clinical Practice Inhaled can effectively improve Patient or Public Contribution No patient public contribution applies work. Study Registration protocol registered PROSPERO International Prospective Register (protocol number CRD42023433194).

Language: Английский

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A Rapid Systematic Review of Pharmacologic Sleep Promotion Modalities in the Intensive Care Unit

Journal of Intensive Care Medicine, Journal Year: 2023, Volume and Issue: 39(1), P. 28 - 43

Published: July 4, 2023

Background: The Society of Critical Care Medicine Clinical Practice Guidelines for Management Pain, Agitation, Delirium, Immobility, and Sleep recommend protocolized non-pharmacologic sleep improvement. Pharmacologic interventions are frequently initiated to promote but the evidence supporting these strategies remains controversial. Purpose: To systematically search synthesize evaluating pharmacologic promotion modalities in critically ill adults. Methods: A rapid systematic review protocol was used Medline, Cochrane Library, Embase reports published through October 2022. We included randomized controlled trials (RCTs) before-and-after cohort studies intended improve adult intensive care unit (ICU) patients. Sleep-related endpoints were primary outcome interest. Study patient characteristics relevant safety non-sleep data also collected. Collaboration Risk Bias or Non-Randomized Studies Interventions assess risk bias all studies. Results: Sixteen (75% RCTs) enrolling 2573 patients included; 1207 allocated intervention. Most utilized dexmedetomidine (7/16; total n = 505 patients) a melatonin agonist (6/16; 592 patients). Only half incorporated as standard care. (11/16, 68.8%) demonstrated significant improvement ≥1 endpoint (n 5 dexmedetomidine, 3 agonists, 2 propofol/benzodiazepines). generally low RCTs moderate-severe Conclusions: Dexmedetomidine agonists most studied modalities, current does not support their routine administration ICU sleep. Future should consider patients' baseline risks disrupted sleep, incorporate protocol, evaluate effect medication on circadian rhythm, physiologic patient-perceived quality, delirium.

Language: Английский

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Nurse-led self-care interventions for older adults with multiple chronic conditions: A protocol for a systematic review and network meta-analysis

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(1), P. e0298082 - e0298082

Published: Jan. 30, 2024

The importance of self-care interventions is progressively recognized, marked by a rapidly aging population that results in growing demands on costly tertiary and institutional care services, placing substantial pressure health social systems. Against this background, study, we will provide evidence for the impact health-related quality life focusing led nurses who can employ integrated approaches. Several databases, including Ovid MEDLINE, Cochrane, CINAHL, Embase, PubMed, be searched along with gray literature to prevent biased results. There no time restrictions, all English abstracts included. Using Template Intervention Description Replication framework, evaluate intervention characteristics. primary outcome life, secondary outcomes symptom burden, physical function, cost-effectiveness. Pairwise network meta-analyses performed, geometry surface under cumulative ranking curve used determine which type nurse-led best older adults multiple chronic conditions. We secure study through PRISMA, AMSTAR 2, RoB 2.0, GRADE checklist. To ensure meta-analysis, similarity checked based PICO framework. consistency meta-analysis transitivity using Bayesian hierarchical protocol registered PROSPERO (CRD42022365467).

Language: Английский

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Effectiveness of sound and darkness interventions for critically ill patients' sleep quality: A systematic review and component network meta‐analysis

Nursing in Critical Care, Journal Year: 2023, Volume and Issue: unknown

Published: Jan. 13, 2023

Abstract Background Noise and lighting are prime factors of poor sleep quality in critically ill patients, which impair recovery increase the risk delirium or complications. Aims To identify rank effectiveness sound darkness interventions on patients. Methods This systematic review component network meta‐analysis was based Preferred Reporting Items for Systematic Reviews incorporating Network Meta‐Analyses (PRISMA‐NMA) Statement. The Embase, MEDLINE, Cochrane CENTRAL, CINAHL, Airiti Library, Google Scholar databases were searched from inception to August 10, 2021, randomized controlled trials (RCTs) targeting patients' quality. We applied standard NMA determine effects interventions. certainty evidence evaluated using risk‐of‐bias tool (V.2.0) online Confidence Meta‐Analysis (CINeMA) application. Results Twenty‐four RCTs with 1507 participants who used combined constituting seven competing included NMA. combination earplugs, eye masks, music; masks alone; earplugs masks; music alone had beneficial intervention effects. best intervention, these components no interaction effect. An mask relative effect, followed by music, quiet time, earplugs. Conclusions study provides clinical improve also recommend future research bedtime nocturnal Relevance practice recommendations that nurses can use

Language: Английский

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Efficacy and safety of acupuncture-point stimulation combined with opioids for the treatment of moderate to severe cancer pain: a network meta-analysis of randomized controlled trials

Frontiers in Oncology, Journal Year: 2023, Volume and Issue: 13

Published: June 2, 2023

Pain is one of the most common and troublesome symptoms cancer. Although potential positive effects acupuncture-point stimulation (APS) on cancer pain have been observed, knowledge regarding selection optimal APS remains unclear because a lack evidence from head-to-head randomized controlled trials (RCTs).This study aimed to carry out network meta-analysis compare efficacy safety different combined with opioids in treating moderate severe rank these methods for practical consideration.A comprehensive search eight electronic databases was conducted obtain RCTs involving pain. Data were screened extracted independently using predesigned forms. The quality appraised Cochrane Collaboration risk-of-bias tool. primary outcome total relief rate. Secondary outcomes incidence adverse reactions, nausea vomiting, constipation. We applied frequentist, fixed-effect model pool effect sizes across rate ratios (RR) their 95% confidence intervals (CI). Network performed Stata/SE 16.0.We included 48 RCTs, which consisted 4,026 patients, investigated nine interventions. A showed that combination superior relieving reducing reactions such as nausea, constipation compared alone. ranking rates follows: fire needle (surface under cumulative curve (SUCRA) = 91.1%), body acupuncture (SUCRA 85.0%), point embedding 67.7%), auricular 53.8%), moxibustion 41.9%), transcutaneous electrical acupoint (TEAS) 39.0%), electroacupuncture 37.4%), wrist-ankle 34.1%). 23.3%), 25.1%), 27.2%), 42.6%), 48.2%), 49.8%), 57.8%), TEAS 76.3%), alone 99.7%).APS seemed be effective opioid-related reactions. Fire may promising intervention reduce well However, not conclusive. More high-quality investigating stability levels interventions must conducted.https://www.crd.york.ac.uk/PROSPERO/#searchadvanced, identifier CRD42022362054.

Language: Английский

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Nursing‐Based Sleep Promotion Intervention Effectiveness for Post Cardiac Surgery Patients: Systematic Review

Journal of Clinical Nursing, Journal Year: 2024, Volume and Issue: 33(12), P. 4528 - 4542

Published: Oct. 6, 2024

Sleep is a fundamental prerequisite for physical and mental health. Poor quality of sleep common among post-cardiac surgery patients leads to serious health conditions.

Language: Английский

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Aromatherapy for Sleep Promotion in the ICU: Insights and Future Directions

Journal of Clinical Nursing, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 9, 2024

ABSTRACT Background The effects of inhaled aromatherapy on sleep quality in critically ill patients the intensive care unit (ICU) have been widely studied. Specific essential oil combinations highlighted for their potential to promote these patients. Aim To offer additional insights and future directions application improving among patients, considering current evidence addressing gaps research. Discussion While certain blends oils, such as lavender, Matricaria recutita, neroli, shown promise, other studies produced mixed results regarding optimal interventions. Integrating with non‐pharmacological approaches, earplugs, eye masks, or music, may enhanced benefits. Further research is needed evaluate aromatherapy's specific populations, intubated assess feasibility, cost‐effectiveness, adverse effects. Conclusion Aromatherapy shows promise but should be integrated evidence‐based, Addressing crucial developing comprehensive strategies enhance ICU settings.

Language: Английский

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Effects of Non‐Pharmacological Interventions on the Swallowing Function of Patients With Post‐Stroke Dysphagia: A Systematic Review and Network Meta‐Analysis

Journal of Oral Rehabilitation, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 12, 2024

Post-stroke dysphagia can lead to serious complications and appropriate rehabilitation significantly improve swallowing function. However, the best method for post-stroke patients is not clear at present stage, so it necessary conduct a comprehensive network meta-analysis systematic review of different interventions dysphagia.

Language: Английский

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