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RES27
The Effect Of Rest And Non-Rest Periods On Physiological Stability, Sedation And Agitation In Ventilated Patients
By: Mellott, K., Grap, M., Hamilton, V., Best, A., Wetzel, P., Munro, C. & Sessler, C.; Virginia Commonwealth University, Richmond, VA
For further information, please contact: mellottkg@vcu.edu
Purpose: This study examines mechanically ventilated patients’ biobehavioral responses during rest and non-rest periods in a Medical Respiratory ICU.
Background/Significance: Rest periods may promote a healing environment through reduction of noise, light, and noxious stimuli which may improve physiological stability, reduce agitation and sedation.
Methods: Twenty-four mechanically ventilated patients (71% female, Mean age= 53, Mean APACHE II score= 28) were studied. Time-synchronized, continuous 24-hour measurements of heart rate (HR), respiratory rate (RR), saturation of oxygen (SpO2), arm and leg movement (agitation), processed EEG (sedation = Patient State Index- PSI), and environmental light and sound were obtained for 435 h (mean 18.2 h/subject). Defined rest periods (2-4p, 1-3a) and non-rest periods (9-11a, 6-8p) were compared using ANOVA.
Results: HR (p< 0.0001) and SpO2 (p< 0.0001) were higher during rest, while RR and leg movement (p< 0.0001) were higher during non-rest periods (p< 0.0001). No difference in arm movement was found. PSI was lower (more sedated) during rest (p< 0.0001). Light and sound levels were lower during rest than during non-rest periods. SpO2 levels were highest during the 2-4p rest period than during all other periods (p< 0.0001). RR was significantly increased during 9-11a, than during all other periods (p< 0.0001). Leg movement was significantly higher during 2-4p, than during all other periods (p< 0.0001). Sound levels were lowest during the 6-8p time, being different than all other time periods (p< 0.0001). Conclusions: Although sound was lower during rest periods, all levels are greater than recommended hospital standards, for both day and night. Rest periods may not be effective in promoting physiologic stability. Future research should investigate this, as well as causative variables and interventions to improve noise levels.
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