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

IF 1.4 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation Pub Date : 2024-09-01 DOI:10.1016/j.ccrj.2024.06.009

Laurie Showler MBChB , Adam M. Deane MBBS PhD , Edward Litton MBChB MSc , Melissa J. Ankravs BPharm MClinPharm , Bradley Wibrow MBBS MSc , Deborah Barge RN RM CCRN , Jeremy Goldin MBBS MM , Naomi Hammond RN MN PhD , Manoj K. Saxena MMBChir BSc , Paul J. Young MBChB PhD , Bala Venkatesh MBBS MD , Mark Finnis MBBS MBiostat , Yasmine Ali Abdelhamid MBBS PhD

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引用次数: 0

Abstract

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.

查看原文本刊更多论文

关于澳大利亚和新西兰重症监护病房住院病人夜间清醒时间和肠道药物助眠的多中心点流行率研究

目标重症患者的睡眠受到干扰。催眠药物可能会改善睡眠；但是，我们需要有关夜间清醒时间和此类药物使用情况的本地流行病学数据。结果 40 个重症监护病房共收治了 532 名患者（中位年龄 60 岁，336 名（63.2%）男性，222 名（41.7%）有创通气患者）。48名患者（9.0%）接受了肠内药物助眠治疗，其中最常用的是褪黑素（28人，5.2%）。据观察，未接受有创通气的患者整夜清醒的时间中位数为 4.0 小时（四分位数间距 (IQR)：2.5, 5.5），接受肠内催眠药的患者之间没有差异（p = 0.9）。据报道，52% 的患者（耳塞）和 63% 的患者（眼罩）没有或无法获得非药物睡眠辅助工具。只有 7 个（17.5%）参与研究的 ICU 制定了睡眠优化干预政策。药物助眠与睡眠时间延长无关。大多数患者没有接受任何非药物辅助治疗，大多数重症监护病房没有制定促进睡眠的地方指南或单位政策。

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来源期刊

Critical Care and Resuscitation CRITICAL CARE MEDICINE-

CiteScore

7.70

自引率

3.40%

发文量

审稿时长

>12 weeks

期刊介绍： ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines. The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world. The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.