The association of sleep quality, delirium, and sedation status with daily participation in physical therapy in the ICU

摘要: Poor sleep is common in the ICU setting and may represent a modifiable risk factor for patient participation ICU-based physical therapy (PT) interventions. This study evaluates association of perceived quality, delirium, sedation, other clinically important factors with was secondary analysis prospective observational single academic medical (MICU). Perceived quality assessed using Richards-Campbell Sleep Questionnaire (RCSQ) delirium Confusion Assessment Method (CAM-ICU). Other covariates included demographics, pre-hospitalization ambulation status, admission diagnosis, daily mechanical ventilation administration benzodiazepines opioids via bolus continuous infusion. Associations PT interventions were among patients eligible multinomial Markov model robust variance estimates. Overall, 327 consecutive MICU completed ≥1 assessment quality. After adjusting all covariates, not associated transitioning to participate following day (relative ratio [RRR] 1.02, 95 % CI 0.96–1.07, p = 0.55). However, had significant negative associations participating subsequent interventions: (RRR 0.58, 0.41–0.76, p <0.001), opioid boluses 0.68, 0.47–0.99, p = 0.04), sedation infusions 0.40–0.85, p = 0.01). Additionally, benzodiazepine further reduced 0.25, 0.13–0.50, <0.001). day. infusions, boluses, particularly when occurring negatively increasing