重症监护病房中的非昼夜节律信号：上午、中午和夜间的时点患病率
Non-circadian signals in the intensive care unit: Point prevalence morning, noon and night.
作者信息
Altman Marcus T, Pulaski Catherine, Mburu Francis, Pisani Margaret A, Knauert Melissa P
机构信息
Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
Section of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine; P.O. Box 208057, New Haven, CT 06520-8057, United States.
出版信息
Heart Lung. 2018 Nov;47(6):610-615. doi: 10.1016/j.hrtlng.2018.07.011. Epub 2018 Aug 22.
BACKGROUND
Intensive care unit (ICU) sleep disturbance is severe and potentially related to abnormal light and sound exposure.
OBJECTIVES
To assess the prevalence of measures of light and sound disturbance in ICU patient rooms, and whether these could be modified by a sleep-promotion intervention.
METHODS
This observational study with a before and after design for a quality improvement initiative surveyed environmental factors in ICU rooms at 01:00 08:00, and 12:00. Surveys assessed light usage, television usage, window shade position, and room door/curtain position. Factors were compared before and after an ICU sleep-promotion intervention.
RESULTS
990 (pre-intervention) and 819 (post-intervention) occupied rooms were surveyed. Pre-intervention, the prevalence of night-time factors included: bright lights on (21%), television on (46%), and room door open (94%). Post-intervention, more rooms had all lights off at night (41% v 50%, p = 0.04), and fewer rooms had open door curtains (57% v 42%, p = 0.001) and window shades (78% v 62%, p = 0.002).
CONCLUSIONS
Disruptive environmental factors are common in the ICU. Some factors improve with sleep-promotion interventions.
背景
重症监护病房（ICU）的睡眠障碍严重，可能与异常的光线和声音暴露有关。
目的
评估ICU病房中光线和声音干扰措施的发生率，以及这些措施是否可以通过促进睡眠的干预措施得到改善。
方法
这项针对质量改进计划的前后设计的观察性研究，在凌晨1点、8点和12点对ICU病房的环境因素进行了调查。调查评估了灯光使用情况、电视使用情况、窗帘位置和房门/帘子位置。在进行ICU促进睡眠干预前后对这些因素进行了比较。
结果
共调查了990间（干预前）和819间（干预后）有患者入住的病房。干预前，夜间因素的发生率包括：开灯（21%）、开电视（46%）和房门打开（94%）。干预后，更多病房夜间所有灯都关闭（41%对50%，p = 0.04），房门帘子打开（57%对42%，p = 0.001）和窗帘打开（78%对62%，p = 0.002）的病房减少。
结论
干扰性环境因素在ICU中很常见。一些因素通过促进睡眠的干预措施得到了改善。
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