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. 2014 Apr;18(2):103-10.
doi: 10.1016/j.smrv.2013.02.002. Epub 2013 May 21.

Sleep of critically ill children in the pediatric intensive care unit: a systematic review

Sapna R Kudchadkar  1 , Othman A Aljohani  2 , Naresh M Punjabi  3
Affiliations

Sleep of critically ill children in the pediatric intensive care unit: a systematic review

Sapna R Kudchadkar et al. Sleep Med Rev. 2014 Apr.

Abstract

Critically ill children in the pediatric intensive care unit (PICU) are exposed to multiple physical, environmental and pharmacologic factors which increase the propensity for sleep disruption and loss and may, in turn, play a role in short-term recovery from critical illness and long-term neurocognitive outcomes. Mechanically ventilated children receive sedative and analgesic medications, often at high doses and for long durations, to improve comfort and synchrony with mechanical ventilation. Sedatives and analgesics can decrease slow wave sleep and rapid eye movement sleep. Paradoxically, sedative medication doses are often increased in critically ill children to improve the subjective assessment of sedation and sleep, leading to further agitation and deterioration of sleep quality. The heterogeneity in age and critical illness encountered in the PICU pose several challenges to research on sleep in this setting. The present article reviews the available evidence on sleep in critically ill children admitted to the PICU, with an emphasis on subjective and objective methods of sleep assessment used and special populations studied, including mechanically ventilated children and children with severe burns.

Keywords: Circadian rhythm; Delirium; Intensive care; Mechanical ventilation; Neonatal; Pediatric; Sleep.

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Figures

Figure 1
Figure 1
Proposed causal pathway for changes in sleep behavior as a modulator of outcomes in critically ill children
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References

    1. Randolph AG, Gonzales CA, Cortellini L, Yeh TS. Growth of pediatric intensive care units in the United States from 1995 to 2001. J Pediatr. 2004;144:792–8. - PubMed
    1. Kudchadkar S, Sterni L, Yaster M, Easley RB. Sleep in the Intensive Care Unit. Contemp Crit Care. 2009;7:1–12.
    1. Friese RS. Sleep and recovery from critical illness and injury: A review of theory, current practice, and future directions. Crit Care Med. 2008;36:2963. - PubMed
    1. Bourne RS, Minelli C, Mills GH, Kandler R. Clinical review: Sleep measurement in critical care patients: research and clinical implications. Crit Care. 2007;11:226. - PMC - PubMed
    1. Parthasarathy S, Tobin MJ. Effect of ventilator mode on sleep quality in critically ill patients. American journal of respiratory and critical care medicine. 2002;166:1423–9. - PubMed

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