人工呼吸中の患者への睡眠評価と睡眠援助―調査分析に基づく検討―

抄録

The analgesia, sedation, and delirium management guidelines (PADIS guidelines) for patients in the adult intensive care unit (ICU) published in 2018 mention the need for proper sleep evaluation and management. A web questionnaire survey on sleep evaluation and intervention status in domestic ICUs, based on the PADIS guidelines, was conducted. The majority of the respondents were physicians working in city hospitals. Approximately 70% of the respondents answered that they performed sleep assessments on patients who are hospitalized, undergoing oral or nasotracheal intubation ventilation, undergoing post-tracheostomy ventilation, and undergoing ventilation with noninvasive positive pressure ventilation. Based on the survey, the most common evaluation method was the subjective evaluation done by nurses, rather than using the Richards-Campbell questionnaire recommended by the PADIS guidelines. More than half of the respondents answered that they dim lights in the patient's room at night, administer sleep medication, and adjust the dose of continuous sedation medication day and night to promote sleep in patients undergoing ventilation. Additionally, 40% of the respondents felt that sleep disturbance during ventilation, while in the ICU, may impact the patient's life after the liberation from the mechanical ventilation. Evidence supporting sleep assistance in ventilated patients remains unclear. Further research is necessary.