需要有创机械通气的严重急性呼吸窘迫综合征幸存者的睡眠质量:一项前瞻性观察研究

IF 2 4区 医学 Q3 CLINICAL NEUROLOGY
Athul Thulasi, Vinod Kumar Sharma, Pawan Kumar Singh, Aman Ahuja, Geetika Arya, Dhruva Chaudhry
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引用次数: 0

摘要

目的:急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)患者在ICU住院期间出现的睡眠障碍可能在出院后持续很长时间。本研究旨在评估重度肺ards幸存者的睡眠质量。方法:这是一项前瞻性观察性研究,招募了所有符合条件的患者,这些患者在有创通气诊断ARDS后存活。分别于出院前和出院后6周采用Epworth嗜睡量表(ESS)、Richards-Campbell睡眠问卷(RCSQ)、失眠严重程度指数(ISI)、匹兹堡睡眠质量指数(PSQI)和1级多导睡眠图(PSG)对受试者进行评估。结果:54例非covid - 19严重ARDS幸存者中有23例,恙虫病是最常见的病因。平均PaO2/FiO2比值为110.90±21.6,APACHE-II评分为19.04±5.1。ICU平均住院时间14.22±10.5 d。出院和6周时ESS和RCSQ平均评分的变化均有统计学意义(早期为5分,晚期为4分)。在6周的随访中,氧去饱和指数也明显下降。13例患者出院后6周出现PSQI bbb5。PaO2/FiO2比值与RCSQ评分呈正相关,机械通气持续时间与6周时PSQI和ISI评分呈正相关(p结论:ARDS患者在ICU出院后早期和晚期均存在睡眠障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quality of sleep in severe acute respiratory distress syndrome survivors requiring invasive mechanical ventilation: a prospective observational study.

Purpose: Sleep disturbances arising during ICU stay among ARDS (acute-respiratory-distress-syndrome) patients may continue long after discharge. This study is aimed at evaluating the sleep quality in severe-pulmonary-ARDS survivors.

Methods: This was a prospective-observational study recruiting all eligible patients, who survived after invasive-ventilation for ARDS diagnosis. Subjects were evaluated just before discharge and at 6-weeks after discharge with Epworth Sleepiness Scale(ESS), Richards-Campbell Sleep Questionnaire(RCSQ), Insomnia severity index(ISI), Pittsburgh Sleep Quality Index (PSQI) and overnight level 1 polysomnography(PSG).

Results: Out of 54 non-COVID19 severe ARDS survivors, 23 were included and Scrub Typhus was the most common etiology. The mean PaO2/FiO2 ratio and APACHE-II scores were 110.90 ± 21.6 and 19.04 ± 5.1, respectively. The mean duration of stay in the ICU was 14.22 ± 10.5 days. The change in mean ESS and RCSQ scores at discharge and 6-weeks were statistically significant (p < 0.001). During the early evaluation, sleep efficiency was low (mean 61.6 ± 7.2% and predominantly N1 and N2 stage) which improved at 6-weeks evaluation (mean 68.52 ± 7.8%, p < 0.001). At 6 -weeks REM component increased from 10.96 ± 2.83 to 15.31 ± 9.96 (p < 0.001). Out of the total 23 patients, 7 had AHI > 5 in early and 4 in late evaluation. Oxygen desaturation index also decreased significantly at 6-weeks follow up. PSQI > 5 was present in 13 patients at 6 weeks after discharge. PaO2/FiO2 ratio had positive correlation with RCSQ score and duration of mechanical ventilation had positive correlation with PSQI and ISI score at 6-weeks (p < 0.001 for all 3).

Conclusion: Sleep disturbances are common in ARDS survivors in both early and late period after discharge from ICU.

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来源期刊
Sleep and Breathing
Sleep and Breathing 医学-呼吸系统
CiteScore
5.20
自引率
4.00%
发文量
222
审稿时长
3-8 weeks
期刊介绍: The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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