PDF(Pubmed)
Abstract：
Sleep deprivation is a prevalent problem in critically ill patients, which leads to delayed recovery and delirium. Slow-wave sleep (SWS) is essential to energy restoration, tissue repair, and immune system strengthening. This study aimed to investigate the effects of gabapentin on SWS in critically ill patients. We performed a prospective open-label randomized controlled study to compare SWS and the clinical outcomes of gabapentin versus a control intervention in critically ill adult patients admitted to the intensive care unit (ICU) within 24 h. The patients\' characteristics and sleep-related outcomes were recorded. The sleep-related outcomes, namely, bispectral analysis (BIS), the Richards-Campbell Sleep Questionnaire (RCSQ), and insulin-like growth factor-1 (IGF-1) levels, were evaluated. Furthermore, clinical outcomes and safety were assessed. Sixty patients from 348 cases were eligible for randomization. On day 3 of the study, patients in the gabapentin group had significantly increased SWS (66.79 vs. 0.00 min; p < 0.001), total sleep time (TST) (331.39 vs. 46.16 min; p = 0.001), RCSQ score (55.05 ± 20.18 vs. 32.80 ± 15.31; p < 0.001), and IGF-1 concentrations (84.33 ± 12.40 vs. 44.00 ± 10.20 ng/mL, p < 0.001) compared with the control group. Improvements in clinical outcomes, such as delirium, ICU-free days, and mechanical ventilator-free days, were observed; however, these differences did not reach statistically significant. Gabapentin at bedtime increased SWS, TST, and IGF-1 concentrations in critically ill patients. This regimen might be beneficial to critically ill patients for improving their sleep quality.
摘要：
睡眠剥夺是危重病人普遍存在的问题,导致恢复延迟和谵妄。慢波睡眠（SWS）对能量恢复至关重要，组织修复,和免疫系统的加强。本研究旨在探讨加巴喷丁对危重患者SWS的影响。我们进行了一项前瞻性开放标签随机对照研究，以比较SWS和加巴喷丁与对照干预在24小时内入住重症监护病房（ICU）的危重成人患者的临床结果。记录患者的特征和睡眠相关结果。与睡眠相关的结果，即,双谱分析（BIS），理查兹-坎贝尔睡眠问卷(RCSQ)，和胰岛素样生长因子-1（IGF-1）水平，进行了评估。此外，评估了临床结局和安全性.348例患者中的60例符合随机化条件。在研究的第三天，加巴喷丁组患者的SWS显着增加（66.79vs.0.00分钟；p<0.001)，总睡眠时间（TST）（331.39vs.46.16分钟；p=0.001)，RCSQ得分（55.05±20.18vs.32.80±15.31；p<0.001），和IGF-1浓度（84.33±12.40vs.44.00±10.20ng/mL,p<0.001）与对照组相比。临床结果的改善，比如谵妄,无ICU天数,和无机械呼吸机的日子，被观察到；然而，这些差异没有达到统计学意义.加巴喷丁在睡前增加了SWS，TST,重症患者的IGF-1浓度。该方案可能有利于改善危重病人的睡眠质量。
