Minerva anestesiologica
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Patients in the Intensive Care Unit (ICU) experience qualitative and quantitative sleep disruption leading to sleep deprivation and adverse sequelae. Patient-related factors, environmental factors, and health-support techniques contribute to sleep disruption. This quality improvement study examines potential factors contributing to poor sleep in the ICU. ⋯ Patients commonly report poor sleep in the ICU related to environmental factors that are potentially modifiable.
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Minerva anestesiologica · Apr 2012
Echocardiographic evaluation and N-terminal pro-brain natriuretic peptide measurement of patients hospitalized for heart failure during weaning from mechanical ventilation.
Weaning patients with heart failure who have required mechanical ventilation remains challenging. We evaluated echocardiographic indexes and N-terminal pro-brain natriuretic peptide (NT-proBNP) as markers of acute cardiac dysfunction before and after spontaneous breathing trials (SBT) in such patients to assess their ability to predict subsequent successful extubation. ⋯ Neither NT-proBNP level nor the studied echocardiographic indices before SBT were able to predict SBT outcome in patients presenting with severe heart failure. Failure to increase the cardiac index and increases in both E/Ea ratio and NT-proBNP levels were seen at end-SBT in patients who failed the SBT, and may reflect failure of myocardial reserve to cope with the stress of SBT.