Crit Care Clin 24 (2008) xiii
Erratum
In the January 2008 issue of Critical Care Clinics, Volume 24, Number 1,
in Dr. Charles W. Hogue’s article, ‘‘Mechanisms of Cerebral Injury from
Cardiac Surgery’’ starting on page 83, an error was made in the section titled
‘‘Hyperglycemia.’’ On page 90 the sentence should read, ‘‘A subsequent trial
using a similar protocol in medical ICU patients found lower morbidity
but higher mortality in patients receiving intensive insulin treatment who
required less than 3 days of ICU admission compared...’’
Crit Care Clin 24 (2008) xi–xii
Preface
Nancy A. Collop, MD
Guest Editor
Sleep is a basic physiologic function of the human body. It is required to
maintain health and to assist in recovery from disease. Unfortunately the
hospital environment is not a very conducive environment for restful sleep.
The ICU is one of the harshest environments for maintaining necessary
sleep and circadian rhythms. In this issue of Critical Care Clinics, we explore
many different aspects of sleep and circadian rhythms and how their disruption
may affect the patient hospitalized in the ICU.
The initial article reviews what occurs during normal sleep, examining its
effects on not only the central nervous system but also other physiologic systems.
The second article delves into the dramatic effects caused by sleep deprivation,
an obvious result of the ICU environs.
The next two articles analyze medication effects. One article looks at the
effects on sleep of the drugs that are commonly used in the ICU setting, an
analysis not often considered when using these medications. Because sleep
disorders are extremely common, the second article is included to review
the effects of common medications used to treat sleep disorders. The purpose
of including this article is to familiarize the intensivist with these medications,
which they may not use regularly.
The next article examines another potential disruptor of sleep in the ICU,
artificial ventilation. Both invasive and noninvasive ventilation have been
shown to have adverse effects on sleep and some studies suggest this disruption
may potentially lead to prolonged time for weaning.
The next four articles are dedicated to examining sleep disorders that
are commonly found in patients admitted to ICUs, including
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doi:10.1016/j.ccc.2008.03.003 criticalcare.theclinics.com
obesity-hypoventilation syndrome, the overlap syndrome (patients who
have both COPD and obstructive sleep apnea), and heart failure complicated
by sleep-disordered breathing syndromes. These three articles critically
appraise these syndromes and how they might affect a patient’s ICU
stay. The fourth article reviews sleep disorders that may be concomitantly
found in ICU patients on admission, again alerting the intensivist to ways
these disorders may adversely affect the underlying diagnoses for ICU
admission.
In the final article, we investigate the potential contributors to sleep and
circadian rhythm disruption in the ICU and methods that the ICU director
and staff may use to minimize that impact on their patients.
In conclusion, I hope you find that this issue of Critical Care Clinics
prompts you to consider the impact of sleep, sleep deprivation, and sleep
disorders on your ICU patients and contemplate ways to improve the
ICU environment and the care of your patients’ sleep needs.
I would like to thank the authors for their excellent contributions to this
issue and Lisa Richman for her patience. I dedicate this issue to my husband,
Tom Collop, for his love, companionship, and unremitting dedication
to our family.
Nancy A. Collop, MD
Division of Pulmonary/Critical Care Medicine
Johns Hopkins University
1830 East Monument Street, Room 555
Baltimore, MD 21205, USA
E-mail address: ncollop1@jhmi.edu
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