Actigraphic monitoring in critically ill patients: Preliminary results toward an "observation-guided sedation"
Actigraphic monitoring in critically ill patients: Preliminary results toward an "observation-guided sedation"
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DOI：
10.1016/j.jcrc.2009.05.006
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发表时间：
2009-12-01
影响因子：
3.7
通讯作者：
Iapichino, Gaetano
中科院分区：
文献类型：
--
作者：
Mistraletti, Giovanni;Taverna, Martina;Iapichino, Gaetano
目的：本研究的目的是评估连续腕关节活动（肢体运动的测量）在重症监护病房的患者作为一个神经状态monitoring.Materials和方法：这是一个前瞻性的，观察性的研究，对运动活动的成年患者使用腕关节活动。护士记录的睡眠和躁动小时数，以及评估疼痛和焦虑水平（口头数字评级）和躁动/镇静水平（里士满躁动镇静量表）。结果：13例机械通气患者进行了研究，在他们的整个重症监护病房停留（共165例/天）。每小时收集调查的运动次数，获得患者运动状态的估计。这种测量方法白天和晚上是不同的（33.3 [20.3-49.0] vs 8.5 [4.4-13.8]; P < .001），与护士估计的睡眠时间相关（白天P = 0.017 [D]，夜间P <0.001 [N]），搅拌时间（P = 0.002 D，P = 0.017 N），里士满躁动-镇静量表值（P <0.001 D和N），疼痛（P = 0.012 D）和焦虑（P <0.001 D）口头数字评分。使用15秒或120秒的时期没有发现差异。结论：患者的肢体运动与所有研究的神经功能状态指标显著相关。连续体动计测量可能成为重要的临床工具，既指导使用镇静药物，并加强早期识别和管理的躁动。(C)2009爱思唯尔公司All rights reserved.
Purpose: The aim of this study is to evaluate continuous wrist actigraphy (measurement of limb movements) in intensive care unit patients as a neurologic status monitoring.Materials and methods: This is a prospective, observational study on motor activity of adult patients using wrist actigraphs. Nurses recorded the number of sleep and agitation hours as well as assessed pain and anxiety level (verbal numeric rating) and the agitation/sedation level (Richmond Agitation-Sedation Scale).Results: Thirteen mechanically ventilated patients were studied during their whole intensive care unit stay (total, 165 patients/d). The number of surveyed movements was gathered for each hour, obtaining an estimation of patient motor status. This measure was different between days and nights (33.3 [20.3-49.0] vs 8.5 [4.4-13.8]; P < .001), with a correlation with sleeping hours estimated by nurses (P = .017 during the days [D], P < .001 during the nights [N]), agitation hours (P = .002 D, P = .0 17 N), Richmond Agitation-Sedation Scale value (P < .001 D and N), pain (P = .012 D), and anxiety (P < .001 D) verbal numeric rating. No differences were found using epochs of 15 or 120 seconds. Compliance with patients and nurses was acceptable.Conclusions: Patients' limb movements were significantly related to all studied neurologic status indexes. Continuous actigraphy measuring may become important as a clinical tool both to guide utilization of sedative drugs and to enhance early recognition and management of agitation. (C) 2009 Elsevier Inc. All rights reserved.