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cover of episode SCCM Pod-536 CCM: Healing Sleep Patterns Post-ICU

SCCM Pod-536 CCM: Healing Sleep Patterns Post-ICU

2025/4/9
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Adriano Targa
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Adriano Targa: 我研究睡眠健康以及它对重症监护幸存者长期康复的影响。良好的睡眠对整体生活质量至关重要,尤其对这些患者而言,因为它与免疫功能和呼吸功能密切相关。我们观察到重症监护幸存者中睡眠质量差的患病率很高,尽管在12个月的随访中有所改善,但昼夜节律的紊乱却持续存在。住院时间和有创机械通气是预测12个月后昼夜节律碎片化的指标。健康人的昼夜节律稳定,活动和休息模式清晰,而重症监护幸存者则表现出昼夜节律的严重碎片化,这可能是由于持续暴露于人工光线、ICU环境中的干扰(噪音、干预措施)以及缺乏日照造成的。ICU住院时间和有创机械通气时间长短可以作为昼夜节律碎片化风险的指标,临床医生可以据此调整后续治疗方案。我们假设ICU环境(而非疾病本身)可能是导致睡眠障碍的主要原因,目前正在进行一项研究,以验证这一假设。我们24个月的随访研究初步结果显示,部分患者需要24个月才能恢复正常的睡眠健康,且睡眠质量的恢复与精神健康密切相关,而昼夜节律则更多地与ICU环境和有创机械通气相关。 Kyle Enfield: 我主持了这次访谈,并就重症监护后睡眠模式恢复的相关问题与Adriano Targa博士进行了探讨。我们讨论了该研究的关键发现,包括重症监护幸存者中睡眠障碍和昼夜节律紊乱的高患病率,以及住院时间和有创机械通气等因素的影响。我们还探讨了改善重症监护幸存者睡眠健康的潜在策略,例如调整ICU环境以减少光线和噪音干扰,以及关注患者的精神健康。

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This study, initially focused on respiratory function in COVID-19 patients, expanded to include sleep evaluation due to limited existing data on sleep health in critical illness survivors. The researchers aimed for a comprehensive evaluation using both subjective and objective measures.
  • Study originated from observing COVID-19 patients.
  • Lack of comprehensive sleep health data in the literature motivated the study.
  • Researchers used both subjective and objective sleep evaluations.

Shownotes Transcript

Host Kyle Enfield, MD, FCCM, welcomes Adriano Targa, PhD, to discuss the article, “Sleep and Circadian Health of Critical Survivors: A 12-Month Follow-Up Study,” published open access in the August 2024 issue of Critical Care Medicine (Henríquez-Beltrán M, et al. Crit Care Med. 2024;52:1206-1217)). They will discuss the prevalence of sleep disturbances and circadian rhythm fragmentation in critical survivors, the impact of factors such as invasive mechanical ventilation and hospitalization duration, and associations among sleep quality, mental health, and respiratory function one year post-discharge.

Dr. Targa is a researcher at the Center for Biomedical Research Network - CIBER in Madrid, Spain.

Find more expert-developed articles from *Critical Care Medicine *at ccmjournal.org).