Locihová Hana, Jarošová Darja, Šrámková Karolína, Slonková Jana, Zoubková Renáta, Maternová Klára, Šonka Karel
Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Faculty of Medicine, University of Ostrava, Ostrava -Vítkovice, Czech Republic; Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava - Vítkovice, Czech Republic.
Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava - Vítkovice, Czech Republic.
J Crit Care Med (Targu Mures). 2025 Jan 31;11(1):23-32. doi: 10.2478/jccm-2024-0043. eCollection 2025 Jan.
Mechanically ventilated patients have disturbed sleep.
To explore whether there is a relationship between successful or unsuccessful weaning of patients and their sleep quality and circadian rhythm.
A scoping review. The search process involved four online databases: CINAHL, MEDLINE, ProQuest, and ScienceDirect. Original studies published between January 2020 and October 2022 were included in the review.
Six studies met the inclusion criteria. These studies showed that patients with difficult weaning were more likely to have atypical sleep, shorter REM sleep, and reduced melatonin metabolite excretion. Muscle weakness was an independent factor associated with prolonged weaning from mechanical ventilation and was significantly more frequent in patients with atypical sleep. Heterogeneous patient samples and the methodology of the studies hamper a clear interpretation of the results.
A relationship was found between abnormal sleep patterns, reduced melatonin metabolite (6-sulfa-toxymelatonin) excretion, and unsuccessful weaning. However, the causality is not clear from the existing research.
机械通气患者存在睡眠障碍。
探讨患者撤机成功与否与其睡眠质量和昼夜节律之间是否存在关联。
进行一项范围综述。检索过程涉及四个在线数据库：护理学与健康领域数据库（CINAHL）、医学索引数据库（MEDLINE）、ProQuest和科学Direct。纳入综述的是2020年1月至2022年10月发表的原始研究。
六项研究符合纳入标准。这些研究表明，撤机困难的患者更有可能出现非典型睡眠、快速眼动睡眠期缩短以及褪黑素代谢产物排泄减少。肌肉无力是与机械通气撤机时间延长相关的独立因素，在非典型睡眠患者中显著更为常见。患者样本的异质性和研究方法妨碍了对结果的清晰解读。
发现异常睡眠模式、褪黑素代谢产物（6-硫酸氧代褪黑素）排泄减少与撤机失败之间存在关联。然而，现有研究尚不清楚其中的因果关系。
