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  • Circadian Hygiene in the ICU Environment (CHIE) study

    Author(s)
    Boots, Rob
    Mead, Gabrielle
    Rawashdeh, Oliver
    Bellapart, Judith
    Townsend, Shane
    Paratz, Jenny
    Garner, Nicholas
    Clement, Pierre
    Oddy, David
    Griffith University Author(s)
    Paratz, Jenny D.
    Year published
    2020
    Metadata
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    Abstract
    Objective: To investigate the environment and care in the intensive care unit (ICU) and its relationship to patient circadian temperature disruption. Design: 30-day, prospective period prevalence study. Setting: 27-bed tertiary ICU. Participants: Patients expected to remain in the ICU for at least 24 hours. Main outcome measures: Temperature, relative humidity, light and sound intensity in the ICU; nursing interventions (using the Therapeutic Intervention Scoring System-28); and core body temperature of ICU patients. Results: Of 28 patients surveyed, 20 (71%) were mechanically ventilated. Median (interquartile range [IQR]) ...
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    Objective: To investigate the environment and care in the intensive care unit (ICU) and its relationship to patient circadian temperature disruption. Design: 30-day, prospective period prevalence study. Setting: 27-bed tertiary ICU. Participants: Patients expected to remain in the ICU for at least 24 hours. Main outcome measures: Temperature, relative humidity, light and sound intensity in the ICU; nursing interventions (using the Therapeutic Intervention Scoring System-28); and core body temperature of ICU patients. Results: Of 28 patients surveyed, 20 (71%) were mechanically ventilated. Median (interquartile range [IQR]) light intensity peaked at 07:00 at 165 (12–1218) lux with a trough at 23:00 of 15 (12–51) lux and was consistently < 100 lux between 21:00 and 06:00. Peak median (IQR) sound intensity was at 07:00 (62.55 [57.87–68.03] dB) while 58.84 (54.81–64.71) dB at 02:00. Ambient temperature and humidity varied with median (IQR) peaks of 23.11°C (22.74–23.31°C) at 16:00 and 44.07% (32.76–51.08%) at 11:00 and median troughs of 22.37°C (21.79–22.88°C) at 05:00 and 39.95% (31.53–47.95%) at 14:00, respectively. Disturbances to sleep during the night occurred due to care activities including linen changes (15 patients, 54%) and bathing (13, 46%). On the day before and the day of the study, 13 patients (47%) and 10 patients (36%), respectively, had a circadian rhythm on core body temperature without an association with illness severity, nursing intervention or environmental measures. Conclusions: The ICU has low light intensity with relative humidity and ambient temperature not aligned to normal human circadian timing. Noise levels are commonly equivalent to conversational speech while patient care procedures interrupt overnight sleep. The contribution of these factors to disrupted CBT rhythmicity is unclear.
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    Journal Title
    Critical care and resuscitation
    Volume
    22
    Issue
    4
    DOI
    https://doi.org/10.51893/2020.4.oa9
    Subject
    Intensive care
    Clinical sciences
    Science & Technology
    Life Sciences & Biomedicine
    Critical Care Medicine
    General & Internal Medicine
    CRITICALLY-ILL PATIENTS
    Publication URI
    http://hdl.handle.net/10072/412345
    Collection
    • Journal articles

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