Sleep-protective vs. sleep-disruptive vital signs
Nondisruptive hemodynamic monitoring
Patients in whom nocturnal stimulation is especially problematic
Greater focus on continuous monitoring may be useful
- Providing adequate sleep and maintaining normal circadian cycles are important to prevent and manage delirium in the ICU.
- The hemodynamic and respiratory status of ICU patients can often be assessed without interrupting sleep using respiratory rate, pulse oximetry, heart rate, urine output (if catheterized), and ventilator parameters (if intubated).
- In patients at low risk of hemodynamic decompensation, blood pressure monitoring may be suspended during sleep if there are other signs available for hemodynamic monitoring (e.g. heart rate and urine output). The ideal monitoring strategy may be determined on a patient-by-patient basis, weighing the risk of hemodynamic deterioration vs. the harm of sleep deprivation.