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改善重症监护病房的睡眠:诊断与治疗选择概述

Improving Sleep in Intensive Care Unit: An Overview of Diagnostic and Therapeutic Options.

作者信息

Tiruvoipati Ravindranath, Mulder Juan, Haji Kavi

机构信息

Department of Intensive Care Medicine, Frankston Hospital, Frankston, Victoria, Australia.

School of Public Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.

出版信息

J Patient Exp. 2020 Oct;7(5):697-702. doi: 10.1177/2374373519882234. Epub 2019 Oct 17.

Abstract

Good quality sleep is considered to be essential for healthy living and recovering from illness. It would be logical to think that good quality sleep is most required when a patient is critically ill in an intensive care unit (ICU). Several studies have demonstrated poor quality of sleep while the patients are in ICU. Subjective tools such as questionnaires while simple are unreliable to accurately assess sleep quality. Relatively few studies have used standardized polysomnography. The use of novel biological markers of sleep such as serum brain-derived neurotrophic factor concentrations may help in conjunction with polysomnography to assess sleep quality in critically ill patients. Attempts to improve sleep included nonpharmacological interventions including the use of earplugs, eye sleep masks, and pharmacological agents including ketamine, propofol, dexmedetomidine, and benzodiazepines. The evidence for these interventions remains unclear. Further research is needed to assess quality of sleep and improve the sleep quality in intensive care settings.

摘要

优质睡眠被认为是健康生活和疾病康复所必需的。由此可以合理推断,当患者在重症监护病房(ICU)处于重症状态时,对优质睡眠的需求最为迫切。多项研究表明,患者在ICU期间睡眠质量较差。诸如问卷调查等主观工具虽然简单,但在准确评估睡眠质量方面并不可靠。相对较少的研究使用标准化多导睡眠图。使用血清脑源性神经营养因子浓度等新型睡眠生物标志物,可能有助于结合多导睡眠图来评估重症患者的睡眠质量。改善睡眠的尝试包括非药物干预,如使用耳塞、眼罩,以及药物治疗,如氯胺酮、丙泊酚、右美托咪定和苯二氮䓬类药物。这些干预措施的证据仍不明确。需要进一步研究来评估重症监护环境中的睡眠质量并改善睡眠质量。

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