Light Intensity on Intensive Care Units- A Short Review

Durrington, Hannah J.

doi:10.21767/2471-8505.100082

Cited by 7 publications

(7 citation statements)

References 36 publications

(44 reference statements)

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“…Chronically disrupted circadian rhythms are associated with long-term cardiovascular consequences such as stroke and myocardial infarction [ 6 ] as well as neurodegenerative diseases such as Parkinson’s disease and dementia [ 7 ]. Thus, there is a growing interest in minimising the disruption of circadian rhythms of patients in the ICU [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Day-to-day progression of vital-sign circadian rhythms in the intensive care unit

et al. 2021

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Background Disrupted vital-sign circadian rhythms in the intensive care unit (ICU) are associated with complications such as immune system disruption, delirium and increased patient mortality. However, the prevalence and extent of this disruption is not well understood. Tools for its detection are currently limited. Methods This paper evaluated and compared vital-sign circadian rhythms in systolic blood pressure, heart rate, respiratory rate and temperature. Comparisons were made between the cohort of patients who recovered from the ICU and those who did not, across three large, publicly available clinical databases. This comparison included a qualitative assessment of rhythm profiles, as well as quantitative metrics such as peak–nadir excursions and correlation to a demographically matched ‘recovered’ profile. Results Circadian rhythms were present at the cohort level in all vital signs throughout an ICU stay. Peak–nadir excursions and correlation to a ‘recovered’ profile were typically greater throughout an ICU stay in the cohort of patients who recovered, compared to the cohort of patients who did not. Conclusions These results suggest that vital-sign circadian rhythms are typically present at the cohort level throughout an ICU stay and that quantitative assessment of these rhythms may provide information of prognostic use in the ICU.

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Section: Introductionmentioning

confidence: 99%

Day-to-day progression of vital-sign circadian rhythms in the intensive care unit

et al. 2021

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“…41,50 Light therapy, or dynamic lighting, has previously been used in non-TBI patients in the ICU and during rehabilitation and has been shown to improve the circadian rhythm and promote recovery. 51 According to stroke patients, the naturalistic light has shown to improve mental health in rehabilitation patients, 52 but the benefits of dynamic light in patients with acute and subacute TBI still needs to be explored.…”

Section: Discussionmentioning

confidence: 99%

Sleep and agitation during subacute traumatic brain injury rehabilitation: A scoping review

Poulsen

Langhorn

Egerod

et al. 2021

Australian Critical Care

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Background: Sleep disturbance and agitation are frequent conditions during the subacute period of recovery in moderate to severe traumatic brain injury (TBI). Clarity is needed regarding the association between the two conditions to improve fundamental nursing care. Aim: The aim of our scoping review was to identify the evidence for potential associations between sleep disturbance and agitation during subacute inpatient rehabilitation of adult patients with moderate to severe TBI. Design: We conducted a five-step scoping review. Methods: Sources of evidence were PubMed, CINAHL, PsycINFO, Cochrane, and Web of Science databases. Eligibility criteria were as follows: English or Scandinavian language articles describing sleep and/or agitation during inpatient rehabilitation of adult patients with moderate to severe TBI and published in the period 2000e2019. Results: We identified 152 articles of which we included six. The included articles were all affiliated with the USA using quantitative methodology. The association between sleep disturbance and agitation is highly complex, with disturbed sleep affecting cognitive and emotional functions. Sleep disturbance was associated with posttraumatic amnesia (PTA)/posttraumatic confusional state, cognitive function, and agitation. Our review suggested a bidirectional association between these symptoms during early TBI rehabilitation. We inferred that improved sleep might be a contributing factor to the resolution of PTA, cognitive impairment, and agitation. Conclusion: The association between sleep disturbance and agitation is still undetermined, but we assume that improved sleep may protect against neuropsychiatric problems in patients with moderate to severe TBI. Larger controlled interventional studies are needed to provide the evidence of modifiable factors for improving sleep during inpatient TBI rehabilitation. Owing to the current lack of publications, it is probably too early to perform a systematic review on the topic.

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“…During the day, there are considerably lower light intensities compared to the environment, but constant light interruptions during the night. 60 Light is the key zeitgeber of the circadian system and influences circadian rhythms and the numerous biochemical processes such as melatonin secretion and thus contributes to an optimal sleep pattern and rapid recovery. 61,62 Medical care and procedures significantly affect patient sleep.…”

Section: Noise and Lightmentioning

confidence: 99%

Updated Perspectives on the Management of Sleep Disorders in the Intensive Care Unit

Nilius¹,

Richter²,

Schroeder³

2021

NSS

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Sleep disorders and circadian dysrhythmias are extremely prevalent in critically ill patients. Impaired sleep has a variety of etiologies, exhibits a wide range of negative effects and, moreover, might deteriorate the patient's prognosis. Despite a number of scientific findings and increased awareness, the importance of sleep optimization is still lower on the list of priories in the intensive care unit (ICU). The techniques of measuring and the evaluation of sleep quantity and quality are a great challenge in the ICU setting. The subjective and objective tools of sleep validation continue to suffer from deficiencies. Treatment approaches to improve the critically ill patient's sleep have focused on nonpharmacologic and pharmacologic strategies with some promising results. But pharmacological interventions alone could not provide sufficient patient benefit. Being aware and knowing of sleep problems and the beneficial effect of the necessary therapies in ICU patients requires greater acceptance. The application of available methods and the development of new methods to prevent sleep disorders in the ICU offer the potential to improve the critically ill patient's outcome.

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Light Intensity on Intensive Care Units- A Short Review

Cited by 7 publications

References 36 publications

Day-to-day progression of vital-sign circadian rhythms in the intensive care unit

Day-to-day progression of vital-sign circadian rhythms in the intensive care unit

Sleep and agitation during subacute traumatic brain injury rehabilitation: A scoping review

Updated Perspectives on the Management of Sleep Disorders in the Intensive Care Unit

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