The goal of the project is to determine the effects of noise masking and noise reduction on stress related physiological parameters in critically ill patients admitted to the intensive care unit.
Sleep deprivation is common in critically ill patients in the intensive care unit (ICU) and may impair recovery. While noise is widely cited as the most common cause of sleep disruption in the ICU setting, its contribution to sympathetic activity in critically ill patients is not known. This is an important knowledge gap, because noise initiates a sequence of physiological changes including vasoconstriction, raised diastolic blood pressure, pupil dilatation and muscle tension. Furthermore, noise is implicated in sympathetic arousals, resulting in a release of adrenaline which prevents relaxation and consequently prevents the patient from falling asleep. The investigators plan to study the effect of noise masking and noise reduction on stress related physiological parameters in critically ill patients admitted to the ICU. Subjects will be randomized into 3 separate groups: control, noise reduction, and noise masking. The investigators will compare the heart rate and blood pressure variability between and within the groups to determine the effects of treatment assignment on these variables. Non-invasive measurements obtained from the bedside monitor will be collected using physiological data acquisition software.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
120
Subjects will wear noise reduction headphones between the hours of 8:00 pm and 8:00 am.
Subjects will wear wear headphones playing relaxing music between the hours of 8:00 pm and 8:00 am.
University of Iowa Hospitals and Clinics
Iowa City, Iowa, United States
Nocturnal LF/HF ratio (a.u.)
The effect of group assignment on nocturnal (8pm to 8am) low frequency/high frequency (LF/HF) ratio will be determined.
Time frame: Day 1 of study
Nocturnal heart rate (bpm)
The effect of group assignment on nocturnal (8pm to 8am) heart rate will be determined.
Time frame: Day 1 of study
Nocturnal RMSSD (ms)
The effect of group assignment on nocturnal (8pm to 8am) root mean square of sequential differences of RR intervals (RMSSD) will be determined.
Time frame: Day 1 of study
Nocturnal blood pressure (mm Hg)
The effect of group assignment on nocturnal (8pm to 8am) blood pressure (mean arterial pressure) will be determined.
Time frame: Day 1 of study
Incidence of ICU delirium
The effect of group assignment on the incidence of ICU delirium as assessed by the CAM-ICU will be determined.
Time frame: Assessed at the time of ICU discharge up to a maximum of 28 days after enrollment, and averaging 4 days after enrollment
Hospital length of stay (days)
The effect of group assignment on hospital length of stay will be assessed.
Time frame: Assessed at the time of hospital discharge up to a maximum of 28 days after enrollment, and averaging 6 days after enrollment.
ICU length of stay (days)
The effect of group assignment on ICU length of stay will be assessed.
Time frame: Assessed at the time of ICU discharge up to a maximum of 28 days after enrollment, and averaging 4 days after enrollment.
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Hospital mortality (%)
The effect of group assignment on in-hospital mortality will be assessed.
Time frame: Assessed at the time of hospital discharge up to a maximum of 28 days after enrollment, and averaging 6 days after enrollment.
Discharged home (%, versus discharge to another health care facility or died)
The effect of group assignment on being discharged directly to home (versus to another skilled care facility or died) from the hospital will be assessed.
Time frame: Assessed at the time of hospital discharge up to a maximum of 28 days after enrollment, and averaging 6 days after enrollment.