- Pharmacology
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The Optimal Dose of Midazolam for Promoting Sleep in Critically Ill Patients: A Pilot Study
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Se Joong Kim, Jisoo Park, Yeon Joo Lee, Jong Sun Park, Ho Il Yoon, Jae Ho Lee, Choon Taek Lee, Young Jae Cho
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Korean J Crit Care Med. 2014;29(3):166-171. Published online August 31, 2014
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DOI: https://doi.org/10.4266/kjccm.2014.29.3.166
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Abstract
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- BACKGROUND
Many critically ill patients treated in the intensive care unit (ICU) experience sleep disruption.
Midazolam is commonly used for the sedation of critically ill patients. This pilot study is aimed to identify the optimal dose of midazolam for achieving sound sleep in critically ill patients. METHODS This prospective study was conducted in the medical ICU of a tertiary referral hospital. Polysomnography recording was performed over 24 hours to assess the quantity and quality of sleep in patients sedated with midazolam. RESULTS A total of five patients were enrolled. Median total sleep time was 494.0 (IQR: 113.5-859.0) min. The majority of sleep was stage 1 (median 82.0 [IQR 60.5-372.5] min) and 2 (median 88.0 [60.5-621.0] min) with scant REM (median 10.0 [6.0-50.5] min) and no stage 3 (0.0 min) sleep.
The median number of wakings in 1 hour was 16.1 (IQR: 7.6-28.6). The dose of midazolam showed a positive correlation with total sleep time (r = 0.975, p = 0.005). CONCLUSIONS The appropriate quantity of sleep in critically ill patients was achieved with a continuous infusion of 0.02-0.03 mg/kg/h midazolam. However, the quality of sleep was poor. Further study is required for the promotion of quality sleep in such patients.
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Citations
Citations to this article as recorded by
- Effect of prolonged sedation with dexmedetomidine, midazolam, propofol, and sevoflurane on sleep homeostasis in rats
Brian H. Silverstein, Anjum Parkar, Trent Groenhout, Zuzanna Fracz, Anna M. Fryzel, Christopher W. Fields, Amanda Nelson, Tiecheng Liu, Giancarlo Vanini, George A. Mashour, Dinesh Pal British Journal of Anaesthesia.2024; 132(6): 1248. CrossRef - Reliability of the Korean version of the Richards-Campbell Sleep Questionnaire
Jae Kyoung Kim, Ju-Hee Park, Jaeyoung Cho, Sang-Min Lee, Jinwoo Lee Acute and Critical Care.2020; 35(3): 164. CrossRef - Pharmacological interventions to improve sleep in hospitalised adults: a systematic review
Salmaan Kanji, Alexandru Mera, Brian Hutton, Lisa Burry, Erin Rosenberg, Erika MacDonald, Vanessa Luks BMJ Open.2016; 6(7): e012108. CrossRef - Sedation in Critically Ill Patients
Mark Oldham, Margaret A. Pisani Critical Care Clinics.2015; 31(3): 563. CrossRef
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