Sleep In Critical Illness

For decades heavily sedated ICU patients were assumed to be asleep. However, in the past 20 years, physiologic and epidemiologic studies have established sleep is frequently disrupted in the ICU. The inter-relationship between ICU sleep, delirium, and survivorship has come to the forefront of ICU practice. We now routinely aim for lighter sedation, delirium assessment has become standardized, and knowledge regarding the ICU factors leading to Post- Intensive Care Syndrome (PICS) has evolved. The importance of sleep in routine ICU management was codified for the first time in SCCM’s 2018 PADIS guidelines. This state of the art book summarizes current knowledge regarding sleep during critical illness and recovery and how the risk factors, recognition, and outcomes associated with sleep in the ICU differ from those of healthy adults. Chapters address sleep quality in both the research environment and during routine care, the factors that disrupt sleep architecture and circadian biology in the ICU setting, medications that alter sleep architecture and those that can be used to improve it, the relationship between sleep and sedation and between sleep and delirium, and current strategies that can be used to improve sleep in the vulnerable ICU population. Written by experts in the field, Sleep in Critical Illness is a valuable resource for all members of the ICU interprofessional team including critical care physicians, nurses, physician assistants, pharmacists, and respiratory therapists as well as clinicians who consult in the ICU and post-ICU settings.

Sedation is a necessary component of care for critically ill and injured individuals. Sedatives assist in coping with mechanical ventilation and other invasive devices, and help patients tolerate procedures and noxious stimuli in the intensive care unit. Sedatives are also useful in the control of agitation and delirium. In addition to fundamental humane reasons, calming patients with sedatives provides physiologic benefits, such as reducing oxygen consumption expended during restlessness, and prevents dislodgement of life-preserving tubes and catheters. When administering sedatives to manage critically ill patients, clinicians must be cognizant of the many complex issues surrounding their use. This issue, edited by Consulting Editor, Dr. Jan Foster, provides current updates in this area, including new guidelines and a focus on delirium.

Clinical practice related to sleep problems and sleep disorders has been expanding rapidly in the last few years, but scientific research is not keeping pace. Sleep apnea, insomnia, and restless legs syndrome are three examples of very common disorders for which we have little biological information. This new book cuts across a variety of medical disciplines such as neurology, pulmonology, pediatrics, internal medicine, psychiatry, psychology, otolaryngology, and nursing, as well as other medical practices with an interest in the management of sleep pathology. This area of research is not limited to very young and old patientsâ€"sleep disorders reach across all ages and ethnicities. Sleep Disorders and Sleep Deprivation presents a structured analysis that explores the following: Improving awareness among the general public and health care professionals. Increasing investment in interdisciplinary somnology and sleep medicine research training and mentoring activities. Validating and developing new and existing technologies for diagnosis and treatment. This book will be of interest to those looking to learn more about the enormous public health burden of sleep disorders and sleep deprivation and the strikingly limited capacity of the health care enterprise to identify and treat the majority of individuals suffering from sleep problems.

Surviving critical illness is not always the happy ending that we imagine for patients. Intensive care unit (ICU) teams have traditionally focused on short term goals such as stabilizing or reversing organ system dysfunction, with little understanding of what became of patients once they left the ICU. However, research conducted in recent years has demonstrated that many ICU survivors can suffer from ill health and mental health issues for months or years to follow. The Textbook of Post-ICU Medicine: The Legacy of Critical Care identifies the long term outcomes of ICU and the steps that can be taken to improve patients' health and wellbeing. Describing the major clinical syndromes affecting ICU survivors, the book delineates established or postulated biological mechanisms of the post-acute recovery process, and discusses strategies for treatment and rehabilitation to promote recovery in the ICU and in the long term. The book serves as a unique reference for general practitioners, internists and nurses caring for long term ICU survivors as well as specialists in intensive care medicine, neurology, psychiatry, and rehabilitation medicine.

Now in paperback, the second edition of the Oxford Textbook of Critical Care is a comprehensive multi-disciplinary text covering all aspects of adult intensive care management. Uniquely this text takes a problem-orientated approach providing a key resource for daily clinical issues in the intensive care unit. The text is organized into short topics allowing readers to rapidly access authoritative information on specific clinical problems. Each topic refers to basic physiological principles and provides up-to-date treatment advice supported by references to the most vital literature. Where international differences exist in clinical practice, authors cover alternative views. Key messages summarise each topic in order to aid quick review and decision making. Edited and written by an international group of recognized experts from many disciplines, the second edition of the Oxford Textbook of Critical Careprovides an up-to-date reference that is relevant for intensive care units and emergency departments globally. This volume is the definitive text for all health care providers, including physicians, nurses, respiratory therapists, and other allied health professionals who take care of critically ill patients.

This issue provideds a comprehensive update to Sleep Medicine in the Intensive Care Unit, with editor Vipin Malik assembling a line-up of key topics such as:Sleep Neurobiology and Critical Care Illness,Obesity Hypoventilation Syndrome and Respiratory Failure,Obstructive Sleep Apnea,Non-Invasive Ventilation in Critically Ill Patients,Restless Leg Syndrome,Sleep and Endocrine System,Congestive Heart Failure and Central Sleep Apnea,Circadian Dysrhythmias,Neuromuscular Disorders and Sleep in Critically Ill Patients, Perioperative Issues and Sleep Disordered Breathing, Seizures, and more!

This book is an introduction to a comprehensive analysis of recent advances and clinical research in noninvasive mechanical ventilation (NIV) in Pulmonary, Critical Care, and Sleep Medicine. The objective of the book is to increase the knowledge and understanding of the reader in the best clinical practice in three main sections. A selected international group of experts in the field of noninvasive ventilation formed a panel to provide an update on the recent literature in the application and efficient utilization of NIV in Pulmonary, Critical Care, and Sleep Medicine. Each particular section will discuss the application of NIV in different disease process. The authors summarized the main results of the recent trials, clinical and technological advances, expert opinions, and practical guidelines. Chapters, summarized by expert committee, provide a “deep and exhaustive critical analysis and summary” of the recent advances in the field of NIV, presented as key points and/recommendations for the best clinical practice from articles published in the last decade. The content of the book will serve as a resource and a tool to the practicing physicians toward NIV. Main objective is to increase their proficiency in management of different pathophysiological aspects of the respiratory system. In this line, the book offers to the readers, who are seeking the latest recommendations, the future research directions in noninvasive mechanical ventilation. Table of contents describe and analyze, the items trend setters in noninvasive ventilation, organized in three main sections, “pulmonary”, “critical care” and “sleep medicine”, using the primary keyword related with term “noninvasive mechanical ventilation” as search term associated with “secondary keywords” studies from a period of 2018 to 2019. This searching methodology and analysis define this unique book to the approach in noninvasive mechanical ventilation for best clinical practice, research, clinical study designs and critical analysis, how noninvasive ventilation is current and trending. Based on this form of conception of book updated, editors and authors consider that this book opens a new and original vision for adequate knowledge and deep updated based on key publications in the period under review, very useful for clinical practice, studies designs and potential new trends in the use of noninvasive ventilation. As such, it is a unique update book resource in noninvasive ventilation in pulmonary, critical care and sleep medicine that may influence current clinical practice and future studies. With ultimate goal is better care and outcome for our patients.