SCCM Resource Library-Circadian Entrainment Cues in the ICU: Bricks in the Road to Critical Illness Recovery

Video Transcription

Video Summary

Video Summary:<br /><br />Dr. Paul Wischmeier discusses the use of intermittent enteral feeding in the ICU. He argues that the current feeding practices, particularly continuous feeding, often result in underfeeding patients. He suggests that intermittent feeding may be a better approach and presents evidence from studies that suggest it may have benefits such as improved protein synthesis and more freedom for rehabilitation activities. Although the evidence on intermittent enteral feeding is limited, ongoing studies are investigating this approach.<br /><br />Melatonin's role in promoting sleep in critically ill patients is still uncertain. Abnormal levels of melatonin have been observed in ICU patients, but the cause of these abnormalities is likely multifactorial. Melatonin and its agonist, remeltion, have been studied as potential treatment options for sleep disruption in the ICU, but the data on melatonin has been underwhelming. Remeltion has shown promise in reducing delirium and sleep disruptions, but larger studies are needed. The ongoing PROMED-IC study is expected to provide more insights. In the meantime, melatonin can be considered as a treatment option, but its use should be individualized. Minimizing light and noise and addressing iatrogenic disruption are important. Overall, further research is needed to better understand the role of melatonin and other medications in promoting sleep in critically ill patients.

Asset Subtitle

Neuroscience, 2020

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2020 Critical Care Congress held February 16-19, 2020, in Orlando, Florida, USA.

Learning Objectives

Recognize the significant interaction between ICU sleep deprivation and ICU circadian disruption
Identify and modify elements of the ICU environment that disrupt circadian health
Apply current evidence to making changes in ICU care that will support circadian health (eg, alternative feeding strategies, ICU mobility protocols)

Sleep-Wake and Circadian Disruption in the ICU: Breaking the Downward Spiral

Melissa Knauert

Optimizing ICU Light Levels: Shining Light in a Dark Place

Melissa Knauert

Intermittent Enteral Feeding: The ICU's New Fad Diet

Paul Wischmeyer

ICU Mobility: Work Out Today, Sleep Better Tonight

Lauren E. Ferrante

Melatonin Use in Critically Ill Patients: Dabbling With the Hormone of Darkness

Mojdeh S. Heavner

Meta Tag

Content Type Presentation

Knowledge Area Neuroscience

Knowledge Level Intermediate

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Sleep Medicine

Year 2020

Keywords

intermittent enteral feeding

ICU

underfeeding patients

continuous feeding

protein synthesis

rehabilitation activities

evidence

studies

melatonin

sleep

critically ill patients

abnormal levels

remeltion

delirium

sleep disruptions

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