Does using pressure-controlled ventilation to rest respiratory muscles improve sleep in ICU patients? - 20/03/13
Corresponding author. Service de Pneumologie et Unité de Réanimation Respiratoire, Centre Hospitalier Universitaire Sud, 80054 Amiens Cedex 1, France. Tel.: +33 3 22 45 59 05; fax: +33 3 22 45 56 54.Summary |
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).
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.
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).
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.
Le texte complet de cet article est disponible en PDF.Keywords : Respiratory muscle, Pressure-controlled ventilation, Pressure-support ventilation, Sleep, Weaning
Plan
Vol 107 - N° 4
P. 534-541 - avril 2013 Retour au numéro
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