It is well-known that patients in the intensive care units do suffer from a lack of sleep and frequent sleep disturbances. So how can we help the ITU patient sleep?
This is a Cochrane review looking at the efficacy of nonpharmacological interventions for sleep promotion in the critically Ill adults in the intensive care units.
Perhaps one of the main results to come from this Cochrane review was the poor quality of the studies that they included. They initially included 30 trials, giving them a total of 1569 participants. However the quality was generally low or very low and as a consequence only three trials, those concerning earplugs or eye masks or both, provided data it suitable for two separate meta-analysis.
I would like in this podcast just to summarise some of the articles that they actually looked at when considering how to optimise the patient’s sleep in the intensive care unit and the various methods used.
Tom, one of my colleagues from the Critical Care Outreach Team and I discuss this paper and its findings reaching our own conclusions. Deferring Arterial Catheterisation in Patients with Septic Shock.
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We return to our 48-year-old patient: jaundiced, hypotensive, drowsy, and bleeding. In decompensated cirrhosis, every treatment targets a disrupted system — splanchnic vasodilation, portal hypertension, toxin accumulation, and renal hypoperfusion.Although these patients look fluid overloaded, they are effectively hypovolaemic. Start with small aliquots of balanced crystalloid, avoiding 0.9% saline. In hepatorenal syndrome or tense ascites, 20% albumin is
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In this episode, I walk through the real-world critical care management of acute decompensated alcohol-related liver disease, using a high-risk ICU case to anchor the discussion. The focus is on understanding the underlying physiology—portal hypertension, rebalanced haemostasis, hepatic encephalopathy, infection, and hepatorenal syndrome—and translating that physiology into clear first-hour priorities at the bedside. Listeners are
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