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Does using pressure-controlled ventilation to rest respiratory muscles improve sleep in ICU patients?
- Source :
-
Respiratory medicine [Respir Med] 2013 Apr; Vol. 107 (4), pp. 534-41. Date of Electronic Publication: 2013 Feb 04. - Publication Year :
- 2013
-
Abstract
- Purpose: Sleep is commonly altered in critically ill patients. Ventilatory mode may impact on quality of sleep. The aim of our study was to evaluate the effect on sleep of pressure-controlled ventilation (PCV) to spontaneous ventilation with 6 cm H2O inspiratory pressure (low-PSV).<br />Methods: Thirty-five patients intubated and mechanically ventilated for acute-on-chronic respiratory failure were included in this prospective randomized cross-over study. Nine were discarded, 13 received PCV first (10 p.m.-2 a.m.) and then low-PSV (2-6 a.m.) and 13 patients received low-PSV first and then PCV.<br />Results: Sleep architecture was altered (50.4% of the night was spent in wakefulness). PCV was associated with significantly improved sleep quality and quantity compared to low-PSV: sleep efficiency (total sleep time/total recording time) was 63% (range: 9-100) vs. 37% (0-96; p = 0.0002), stage 2 NREM sleep was 33% vs. 13% (p = 0.0005), stages 3 and 4 NREM sleep were 9% vs. 3.5% (p = 0.003) and REM sleep was 6.5% vs. 0% (p = 0.003).<br />Conclusions: Sleep quantity and quality were significantly improved with PCV compared to low-PSV. Nocturnal respiratory muscles rest through PCV is recommended to improve sleep in ICU patients with acute-on-chronic respiratory failure.<br /> (Copyright © 2012 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Critical Care methods
Cross-Over Studies
Double-Blind Method
Forced Expiratory Volume physiology
Humans
Intensive Care Units
Middle Aged
Muscle Relaxation physiology
Polysomnography methods
Positive-Pressure Respiration adverse effects
Respiratory Insufficiency physiopathology
Sleep Stages physiology
Sleep Wake Disorders etiology
Sleep Wake Disorders physiopathology
Ventilator Weaning methods
Vital Capacity physiology
Positive-Pressure Respiration methods
Respiratory Insufficiency therapy
Respiratory Muscles physiopathology
Sleep Wake Disorders prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1532-3064
- Volume :
- 107
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Respiratory medicine
- Publication Type :
- Academic Journal
- Accession number :
- 23391488
- Full Text :
- https://doi.org/10.1016/j.rmed.2012.12.012