Relationship Between Sleep Disorders And Acquired Weakness Of ICU In Critically Ill Patients

Objective:To explore the correlation between sleep disorder and acquired weakness of ICU,and to determine whether it is an independent risk factor for ICU-AW,in order to find better intervention and treatment targets,and to provide new ideas for the pathogenesis,prevention or treatment of ICU-AW.Methods:A survey was conducted on 63 critically ill patients who were treated in the third ward of the Department of critical Medicine,the second Hospital of Shanxi Medical University from January 2020 to January 2021.The electronic grip strength meter was used to identify ICU-AW(the cutoff value of ICU-AW was: male < 11 kg,female < 7 kg).According to whether ICU-AW was diagnosed or not,they were divided into two groups(ICU-AW group and non-ICU-AW group).The basic conditions of the patients were recorded,including age,sex,acute physiology and chronic health score,muscle strength values after admission to ICU(≥3 days),serum albumin,blood glucose and lactic acid values,and whether sedatives,analgesics,hormones,neuromuscular blockers,vasoactive drugs and blood purification therapy were given.Whether parenteral nutrition was given,whether it was diagnosed as Sepsis and multiple organ dysfunction syndrome,whether surgical treatment was performed after admission,and the time of mechanical ventilation and hospitalization in ICU were calculated.The sleep breathing indexes included sleep apnea hypopnea index,total sleep time,sleep efficiency,deep sleep time,light sleep time,rapid eye movement time,awakening time and the percentage of deep sleep time.Using SPSS26.0 statistical software,t-test and Mann-Whitney test were used for measurement data,and the results were expressed by mean ±standard deviation((?)±s)and median(quartile spacing).Chi-square test was used for counting data,and binary logistics multivariate regression analysis was used to calculate the correlation between various factors and ICU-AW,P<0.05 indicates the difference is statistically significant.Pearson correlation analysis was used to analyze the correlation between muscle strength and deep sleep time,serum albumin and age in critically ill patients.Results:1.The incidence of ICU-AW in the third ward of the Department of critical Medicine,the second Hospital of Shanxi Medical University was 47.6%.2.Univariate analysis showed that ICU-AW group was compared with non-ICU-AW group.There were significant differences in age,sex,APACHEII score,muscle strength,mechanical ventilation time,sepsis,multiple organ dysfunction syndrome,serum albumin,serum glucose,lactic acid,sedatives,analgesics,neuromuscular blockers,parenteral nutrition,operation after admission,total sleep time,sleep efficiency,deep sleep time and the ratio of deep sleep time to total sleep time(p<0.05).There was no significant difference between the two groups in ICU hospitalization time,glucocorticoid,vasoactive drugs,blood purification treatment,respiratory disorder index(AHI),light sleep time,REM time,awakening time and so on(p>0.05).3.Binary logistics multivariate regression analysis showed that age,serum albumin,deep sleep time,surgical treatment after admission and multiple organ dysfunction syndrome were statistically significant.4.Muscle strength in critically ill patients was positively correlated with deep sleep time and serum albumin,but negatively correlated with age(p < 0.05).Conclusion:1.Acquired weakness is a common complication in critically ill patients with ICU.2.Age,sex,APACHEII score,mechanical ventilation time,sepsis,multiple organ dysfunction syndrome,serum albumin,serum glucose,lactic acid,sedatives,analgesics,neuromuscular blockers,parenteral nutrition,operation after admission,total sleep time,sleep efficiency,deep sleep time and the ratio of deep sleep time to total sleep time were related to the occurrence of ICU-AW.3.Age,serum albumin,deep sleep time,surgical treatment after admission and multiple organ dysfunction syndrome were independent risk factors for ICU-AW.4.The smaller the muscle strength of critically ill patients,the shorter the time of deep sleep,the lower the level of serum albumin.