Sleep In The Icu

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.

This text is one of the first comprehensive resources on understanding and working with families in the intensive care unit. The text provides a conceptual overview of the Family ICU Syndrome, a constellation of physical morbidity, psychopathology, cognitive deficits, and conflict. Outlining its mechanisms, the book presents a guide to combating the syndrome with an interdisciplinary team. The text represents the full array of the interdisciplinary team by also spotlighting administrative considerations for health care management and approaches to training different members of the health care team. Family voices are featured prominently in the text as well. The book also addresses the complete trajectory of needs of care, including survivorship and end-of-life care. Written by experts in the field, Families in the Intensive Care Unit: A Guide to Understanding, Engaging and Supporting at the Bedside is a state-of-the-art reference for all clinicians who work with families in the ICU.

The fully updated second edition of this popular handbook concisely summarises all current knowledge about delirium in critically ill patients and describes simple tools the bedside clinician can use to prevent, diagnose and manage delirium. Chapters discuss new developments in assessing risk and diagnosis, crucial discoveries regarding delirium and long-term cognitive outcomes, and dangers of sedation and death. Updated management advice reflects new evidence about antipsychotics and delirium. This book explains how to minimise the risks of delirium, drugs to avoid, drugs to use and when to use them, as well as current theories regarding pathophysiology, different motoric subtypes leading to missed diagnosis, and the adverse impact of delirium on patient outcomes. While there are still unanswered questions, this edition contains all the available answers. Illustrated with real-life case reports, Delirium in Critical Care is essential reading for trainees, consultants and nurses in the ICU and emergency department.

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.

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!

According to research, more than 50% of patients seen in psychiatric clinics have sleep problems. Despite this fact, there is a lack of sleep medicine training in psychiatric residency programs especially for disorders like insomnia and sleep-related problems in women and children. Also, there is a lack of education on treating sleep problems in special situations like ICU settings or managing sleep problems via telemedicine. Sleep physicians, on the other hand, are uncomfortable treating patients with the psychiatric disorders, particularly in this demographic. Pediatricians are also not trained to work with children suffering from sleep disturbances or psychiatric disorders. They often struggle to correctly identify a particular disorder and lack confidence to adequately treat and manage these issues. In total, there are only about 250 clinicians trained in both sleep medicine and psychiatry, despite the millions of patients who could benefit from both disciplines. While Springer does have a forthcoming text on sleep and psychiatric disturbances that addresses comorbid sleep disorders in the general population, there is still no resource that examines the intricacies of insomnia in women and children. This text highlights the importance of common medical comorbidities and illuminates the salient points for treatment, diagnosis, and management of these conditions as they relate particularly to these special populations. Written by experts in both sleep medicine and psychiatry, the text takes a cutting-edge, reader-friendly approach to topics that include sleep disturbances in pregnancy, sleep tele-medicine, sleep disturbances related to difficulties in schools, and substance-induced disturbances. Each chapter follows a consistent format, making it an excellent tool for the busy clinician who is not able to sift through scientific literature or didactic texts. Psychiatric Sleep Disorders in Women and Children is an excellent resource for all clinicians who may work with special populations struggling with sleep and psychiatric comorbidities, including psychiatrists, sleep medicine physicians, internists, primary care and family medicine physicians, pediatricians, obstetrics/gynecologists, psychologists and others.