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Common Sense Approaches May Stem ICU Delirium

Helping patients sleep lessens odds of confusion, study finds

FRIDAY, Feb. 22 (HealthDay News) -- A few simple steps can help patients in the intensive care unit sleep better and reduce their risk of delirium, according to a new study.

Lack of sleep can cause delirium, which can lead to short- and long-term confusion and memory problems, explained the researchers from Johns Hopkins University in Baltimore.

The study involved implementing measures to reduce ICU patients' exposure to night-time noise, light and staff interruptions, and stopping certain medications for insomnia.

"With our interventions, we were able to improve a patient's odds of being free of delirium in the ICU by 54 percent, even after taking into account the diagnosis, need for mechanical ventilation, age and other factors," Dr. Biren Kamdar, a pulmonary and critical care fellow who led the initiative, said in a university news release.

"In addition, many patients said that the ICU was quiet and comfortable enough for them to get a good night's sleep," Kamdar said.

The study appears online and in the March print issue of the journal Critical Care Medicine.

The measures used to help patients get a better night's sleep included: turning off televisions and room and hallway lights; minimizing unnecessary medical-equipment alarms; safely reducing the number of staff visits to patient rooms overnight for giving medications and drawing blood; offering patients eye masks, ear plugs and tranquil music; and reducing the use of commonly prescribed sleep drugs known to cause delirium.

"Delirium is a syndrome of confused thinking and lack of attention," study senior author Dr. Dale Needham, an associate professor of pulmonary and critical care medicine, said in the news release. "It typically comes on quickly with illness, and it's a marker for the health of the brain."

"We put together a common-sense approach to change how care is provided to see if by improving sleep, we could reduce patients' confused thinking, and it was effective," Needham noted.

More information

The MedlinePlus Medical Encyclopedia has more about delirium.


SOURCE: Johns Hopkins Medicine, news release, Feb. 20, 2013

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