Full Description
For decades heavily sedated ICU patients were assumed to be asleep. However, in the past 20 years, physiologic and epidemiologic studies have established sleep is frequently disrupted in the ICU. The inter-relationship between ICU sleep, delirium, and survivorship has come to the forefront of ICU practice. We now routinely aim for lighter sedation, delirium assessment has become standardized, and knowledge regarding the ICU factors leading to Post- Intensive Care Syndrome (PICS) has evolved. The importance of sleep in routine ICU management was codified for the first time in SCCM's 2018 PADIS guidelines.
This state of the art book summarizes current knowledge regarding sleep during critical illness and recovery and how the risk factors, recognition, and outcomes associated with sleep in the ICU differ from those of healthy adults. Chapters address sleep quality in both the research environment and during routine care, the factors thatdisrupt sleep architecture and circadian biology in the ICU setting, medications that alter sleep architecture and those that can be used to improve it, the relationship between sleep and sedation and between sleep and delirium, and current strategies that can be used to improve sleep in the vulnerable ICU population. Written by experts in the field, Sleep in Critical Illness is a valuable resource for all members of the ICU interprofessional team including critical care physicians, nurses, physician assistants, pharmacists, and respiratory therapists as well as clinicians who consult in the ICU and post-ICU settings.
Contents
Characteristics of sleep in critically ill patients. Part I: Sleep fragmentation and sleep stage disruption.- Characteristics of sleep in critically ill patients. Part II: Circadian rhythm disruption.- Unique neurophysiologic findings in the critically ill: "Atypical sleep and pathologic wakefulness".- Normal sleep compared to altered consciousness during sedation.-Biologic effects of disrupted sleep.- Risk factors for disrupted sleep in the ICU.- Effects of common ICU medications on sleep.- Sleep disruption and its relationship with delirium: Electroencephalographic perspectives.- Sleep disruption and its relationship with delirium: Clinical perspectives.- Mechanical ventilation and sleep.- ICU sleep disruption and its relationship with ICU outcomes.- Long-term outcomes--sleep in survivors of critical illness.- Methods for routine ICU sleep assessment and monitoring.- Best practices for improving sleep in the ICU. Part 1: Non-pharmacologic.- Best practices for improving sleep in the ICU. Part II: Pharmacologic.- Sleep considerations in critically ill children.- Sleep in Critical Illness: Future Directions.
