Crit Care:体动记录仪监测重症监护患者睡眠的可行性和可靠性分析

2021-01-29 MedSci原创 MedSci原创

在区分睡眠和觉醒状态方面,体动记录仪与多导睡眠描记仪有一定的一致性,并且使用方便、安全,可能是检测重症监护患者睡眠的一种合理选择。

重症监护病人睡眠减少且高度片段化,这可能对患者的恢复造成不利影响。目前重症监护临床医生面临的挑战是缺乏明确可行的和准确的睡眠评估方法,以便广泛使用。
近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,该研究旨在探讨微创睡眠监测技术与多导睡眠描记仪相比在睡眠监测方面的可行性和可靠性。

该前瞻性观察研究通过24小时多导睡眠描记仪和体动记录仪对最低限度镇静的患者进行睡眠监测,以评估两种方法的一致性、总睡眠时间和觉醒时间。

研究人员招募了80名重症监护室接受机械通气(24%)和未进行机械通气(76%)的患者。睡眠被发现是高度片段化,由无数次的睡眠发作组成,并以异常的睡眠结构为特征。
在多导睡眠描记仪识别睡眠和清醒状态方面,体动记录仪与多导睡眠描记仪的结果总体一致性达到中等水平(69.4%;K=0.386,p< 0.05),敏感性为65.5%,特异性为76.1%。在未进行机械通气的患者中,通过体动记录仪监测的准确性得到了显著改善(特异性为83.7%;灵敏度为56.7%)。体动记录仪与多导睡眠描记术报告的总睡眠时间(r=0.359,p<0.05)和清醒程度(r=0.371,p<0.05)中度相关。Bland-Altman图显示,体动记录仪低估了睡眠,而高估了觉醒状态。

由此可见,在区分睡眠和觉醒状态方面,体动记录仪与多导睡眠描记仪有一定的一致性,并且使用方便、安全,可能是检测重症监护患者睡眠的一种合理选择

原始出处:

L. J. Delaney.et al.The feasibility and reliability of actigraphy to monitor sleep in intensive care patients: an observational study.Critical Care.2021.https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-03447-8

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    2021-11-09 湘雅科教

    已拜读,受益匪浅。

    0

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    2021-01-31 bioon6
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    2021-01-30 carrotlyl

    新方向

    0

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    2021-01-29 ms2000001051330459

    学习了,涨知识了!

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