Publication: Sleep and pathological wakefulness at the time of liberation from mechanical ventilation (SLEEWE) a prospective multicenter physiological study
Issued Date
2019-05-01
Resource Type
ISSN
15354970
1073449X
1073449X
Other identifier(s)
2-s2.0-85065069678
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Respiratory and Critical Care Medicine. Vol.199, No.9 (2019), 1106-1115
Suggested Citation
Martin Dres, Magdy Younes, Nuttapol Rittayamai, Tetyana Kendzerska, Irene Telias, Domenico Luca Grieco, Tai Pham, Detajin Junhasavasdikul, Edmond Chau, Sangeeta Mehta, M. Elizabeth Wilcox, Richard Leung, Xavier Drouot, Laurent Brochard Sleep and pathological wakefulness at the time of liberation from mechanical ventilation (SLEEWE) a prospective multicenter physiological study. American Journal of Respiratory and Critical Care Medicine. Vol.199, No.9 (2019), 1106-1115. doi:10.1164/rccm.201811-2119OC Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51708
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Title
Sleep and pathological wakefulness at the time of liberation from mechanical ventilation (SLEEWE) a prospective multicenter physiological study
Other Contributor(s)
Li Ka Shing Knowledge Institute
AP-HP Assistance Publique - Hopitaux de Paris
Centre Hospitalier Universitaire de Poitiers
Saint Michael's Hospital University of Toronto
University of Toronto
Faculty of Medicine, Siriraj Hospital, Mahidol University
Mount Sinai Hospital of University of Toronto
Toronto Western Hospital University of Toronto
Ottawa Hospital Research Institute
YRT Ltd
Sleep Disorders Centre
AP-HP Assistance Publique - Hopitaux de Paris
Centre Hospitalier Universitaire de Poitiers
Saint Michael's Hospital University of Toronto
University of Toronto
Faculty of Medicine, Siriraj Hospital, Mahidol University
Mount Sinai Hospital of University of Toronto
Toronto Western Hospital University of Toronto
Ottawa Hospital Research Institute
YRT Ltd
Sleep Disorders Centre
Abstract
Copyright © 2019 by the American Thoracic Society. Rationale: Abnormal patterns of sleep and wakefulness exist in mechanically ventilated patients. Objectives: In this study (SLEEWE [Effect of Sleep Disruption on the Outcome of Weaning from Mechanical Ventilation]), we aimed to investigate polysomnographic indexes as well as a continuous index for evaluating sleep depth, the odds ratio product (ORP), to determine whether abnormal sleep or wakefulness is associated with the outcome of spontaneous breathing trials (SBTs). Methods: Mechanically ventilated patients from three sites were enrolled if an SBT was planned the following day. EEG was recorded using a portable sleep diagnostic device 15 hours before the SBT. The ORP was calculated from the power of four EEG frequency bands relative to each other, ranging from full wakefulness (2.5) to deep sleep (0). The correlation between the right and left hemispheres’ ORP (R/L ORP) was calculated. Measurements and Main Results: Among 44 patients enrolled, 37 had technically adequate signals: 11 (30%) passed the SBT and were extubated, 8 (21%) passed the SBT but were not deemed to be clinically ready for extubation, and 18 (49%) failed the SBT. Pathological wakefulness or atypical sleep were highly prevalent, but the distribution of classical sleep stages was similar between groups. The mean ORP and the proportion of time in which the ORP was .2.2 were higher in extubated patients compared with the other groups (P, 0.05). R/L ORP was significantly lower in patients who failed the SBT, and the area under the receiver operating characteristic curve of R/L ORP to predict failure was 0.91 (95% confidence interval, 0.75–0.98). Conclusions: Patients who pass an SBT and are extubated reach higher levels of wakefulness as indicated by the ORP, suggesting abnormal wakefulness in others. The hemispheric ORP correlation is much poorer in patients who fail an SBT.