From: Role of sleep on respiratory failure after extubation in the ICU
N = 52 | |
---|---|
Patient characteristics | |
Age (years) | 68 [59–76] |
Male sex, n (%) | 35 (67%) |
Body mass index (kg/m2) | 30 [25–34] |
Simplified Acute Physiological Score II at admission (points) | 48 [36–62] |
Acute respiratory failure as main reason of intubation, n (%) | 43 (83%) |
Duration of mechanical ventilation before extubation (days) | 9 [4–16] |
Sedation before polysomnography (number of days) | 3 [2–9] |
Sedation-free days at time of polysomnography (days) | 3 [2–5] |
Difficult or prolonged weaninga, n (%) | 18 (35%) |
Respiratory parameters before extubation | |
Maximal inspiratory pressure (cmH2O) | 51 [36–62] |
P0.1 (cmH2O) | 3.4 [3.3–3.6] |
pH, units | 7.46 [7.43–7.49] |
PCO2 (mmHg) | 41[36–45] |
PaO2/FiO2 (mmHg) | 250 [186–300] |
Ineffective cough, n (%) | 6 (12%) |
Abundant secretions, n (%) | 11 (21%) |
Clinical parameters at time of PSG | |
Sequential Organ Failure Assessment (points) | 3 [2–4] |
Richmond Agitation Sedation Scale (points) | 0 [0–0] |
Intensive care delirium screening checklist (points) | 0.0 [0.0–1.5] |
Delirium, n/n assessed (%) | 8/51 (16%) |
Medical Research Council (MRC) score (points) | 52 [36–60] |
ICU-acquired weakness (MRC < 48), n/n total (%) | 17/44 (39%) |
Prophylactic noninvasive ventilation, n (%) | 26 (50%) |
Sleep quantity | |
Duration of polysomnography recording (h) | 16.7 [14.9–17.4] |
Sleep duration (h) | 2.4 [1.1–4.2] |
Sleep efficiency (%) | 16 [7–24] |
Duration of light or atypical sleep (min) | 94 [46–175] |
Duration of deep sleep stage 3 (min) | 17 [0–66] |
Duration of REM sleep stage (min) | 0 [0–8] |
Sleep quality | |
Absence of deep sleep, n (%) | 15 (29%) |
Absence of REM sleep, n (%) | 33 (63%) |
Atypical sleep, n (%) | 10 (19%) |
Pathological wakefulness, n (%) | 12 (23%) |
Altered EEG reactivity at eye-opening test, n/n assessed (%) | 15/48 (31%) |
Sleep fragmentation | |
Arousals and awakenings, events per hour of sleep | 25 [13–32] |
Average sound pressure level, decibels | 57 [55–61] |
Sound level events above 60 decibels, n events/h | 27 [19–39] |
Outcomes | |
Post-extubation respiratory failure, n (%) | 12 (23%) |
Reintubation within the 7 days following extubation, n (%) | 7 (13%) |
Reintubation in ICU, n (%) | 8 (15%) |
Mortality in ICU, n (%) | 1 (2%) |