ICU Literature Updates from September 2014

Evaluation of Continuous Positive Airway Pressure Therapy on Renin–Angiotensin System Activity in Obstructive Sleep Apnea

Renal failure and obstructive sleep apnea are two conditions that have serious implications in the intensive care unit. In this article the authors exam the interaction between obstructive sleep apnea and renal dysfunction. The authors note that OSA has been associated with loss of kidney function, which may be related to the renin-angiotensen system. The authors sought to evaluate the effects of continuous positive airway pressure on renal hemodynamics. Twenty normatensive, nondiabetic, newly diagnosed OSA were evaluated pre and post CPAP therapy. The authors measured glomerular filtration rate, renal plasma flow, and filtration fraction. The authors found that CPAP therapy was associated with improved renal hemodymamics and down regulation of renal RAS activity. This suggests that CPAP therapy could have therapeutic benefit for renal function under-scoring the importance of treating OSA in the ICU.

Trajectories of Sleep and Its Predictors in the First Year Following Traumatic Brain Injury

Traumatic brain injury is a common reason for admission to the ICU. Hence, it is timely that the authors of this study evaluated the relationship between sleeep and TBI. In this study, the authors evaluated sleep measured by actigraphy for 7 consecutive days in the first, third, sixth, and twelfth month following TBI. The authors found that poor sleep efficiency is a common symptom in the first year among patients with first-ever TBI. The authors recommend that those who care for these patients should consider both mental health and pain issues when dealing with sleep complaints in patients with TBI.