2024
Early goal enteral nutrition associated with decreased in-hospital death in mechanically ventilated critically ill adults: a retrospective cohort study
Powierza C, Doyle M, Wasden K, Intihar T, Korwin A, Honiden S, Knauert M. Early goal enteral nutrition associated with decreased in-hospital death in mechanically ventilated critically ill adults: a retrospective cohort study. BMJ Open Respiratory Research 2024, 11: e001962. PMID: 38749534, PMCID: PMC11097881, DOI: 10.1136/bmjresp-2023-001962.Peer-Reviewed Original ResearchConceptsEarly enteral nutritionIn-hospital deathCritically ill adultsRetrospective cohort studyDays of intubationEnteral nutritionIll adultsAdult patientsCohort studyAssociated with decreased in-hospital deathsMechanically ventilated critically ill adultsGoal enteral nutritionIncreased hospital dischargeInitiation of ENCritically ill adult patientsMechanically ventilated adult patientsIncidence of in-hospital deathMedical intensive care unitAssociated with significant improvementsIll adult patientsDose of ENIntensive care unitClinical outcomesImprove mortalityPrimary outcomeIntensive care unit interventions to promote sleep and circadian biology in reducing incident delirium: a scoping review
Wilcox M, Burry L, Englesakis M, Coman B, Daou M, van Haren F, Ely E, Bosma K, Knauert M. Intensive care unit interventions to promote sleep and circadian biology in reducing incident delirium: a scoping review. Thorax 2024, 79: 988-997. PMID: 38350730, DOI: 10.1136/thorax-2023-220036.Peer-Reviewed Original ResearchSeverity of deliriumIntensive care unitIncident deliriumCare bundleReducing incident deliriumSensitive search of electronic databasesSearch of electronic databasesEnglish-language studiesPromote sleepPromotion interventionsEvaluate interventionsIntensive care unit interventionsElectronic databasesNon-pharmacologicalInclusion criteriaIntervention strategiesDeliriumInterventionCare unitEye maskConference proceedingsVariable reportingSleepPharmacological interventionsAssociation
2023
Consecutive Inpatient Hematology Consultation Service Utilization across 11 Years in the Medical Intensive Care Unit
Allen C, Streiff M, Naik R, Knauert M, Goshua G. Consecutive Inpatient Hematology Consultation Service Utilization across 11 Years in the Medical Intensive Care Unit. Blood 2023, 142: 2323. DOI: 10.1182/blood-2023-184891.Peer-Reviewed Original ResearchMedical intensive care unitIntensive care unitHematology consultationCare unitHematology consultMICU admissionLymphoproliferative disordersHematologic malignanciesMalignant hematologyService utilizationConsecutive patients 18 yearsHospital discharge statusPatients 18 yearsCritical care managementRetrospective observational studySingle academic centerPlasma cell dyscrasiaQuality improvement metricsDay of consultationHigh clinical volumeService needsDescriptive statisticsExpedient careICU consultationBaseline demographics0842 Feasibility of daytime bright light exposure and urinary 6-sulfatoxymelatonin profiling in the medical ICU: A pilot study
Intihar T, Doyle M, Lukas M, Wright K, Redeker N, Pisani M, Yaggi H, Knauert M. 0842 Feasibility of daytime bright light exposure and urinary 6-sulfatoxymelatonin profiling in the medical ICU: A pilot study. Sleep 2023, 46: a371-a371. DOI: 10.1093/sleep/zsad077.0842.Peer-Reviewed Original ResearchMedical intensive care unitMICU patientsDaytime bright light exposureStudy days 1Intensive care unitIllness severity scoresBright light exposureWarrants further investigationCircadian outcomesMedical ICUCritical illnessIll patientsOngoing RCTsCare unitCircadian timingMean ageMelatonin useCircadian phaseSeverity scorePilot trialSufficient urinePatientsStudy daysBright lightDay 1
2022
Best Practice for Improving Sleep in the ICU. Part I: Non-pharmacologic
Korwin A, Knauert M. Best Practice for Improving Sleep in the ICU. Part I: Non-pharmacologic. 2022, 231-248. DOI: 10.1007/978-3-031-06447-0_14.ChaptersIntensive care unitICU patientsNormal sleepCritical care treatmentNon-pharmacologic therapiesNon-pharmacologic interventionsMost ICU patientsAbnormal circadian rhythmPoor quality sleepCircadian functionAcute illnessCritical illnessPatient characteristicsIll adultsCare unitChronotherapeutic interventionsCare treatmentSleep preferenceCurrent evidencePatient careCircadian disruptionSleepPatientsFuture interventionsPractice changeSleep in Critical Illness: Future Directions
Knauert M, Parthasarathy S. Sleep in Critical Illness: Future Directions. 2022, 291-309. DOI: 10.1007/978-3-031-06447-0_17.ChaptersIntensive care unitCritical illnessSleep disruptionSleep promotionCircadian disruptionAcute illness factorsCritical care outcomesCritical illness outcomesAspects of sleepICU sleepCare unitICU cliniciansIllness factorsPatient outcomesMethodologic limitationsIllness outcomesSleep interventionsCare outcomesClinical practiceSleep measuresSleep deficiencyNatural historyLimited evidenceSleepIllness
2020
Pilot Observational Study to Detect Diurnal Variation and Misalignment in Heart Rate Among Critically Ill Patients
Knauert MP, Murphy TE, Doyle MM, Pisani MA, Redeker NS, Yaggi HK. Pilot Observational Study to Detect Diurnal Variation and Misalignment in Heart Rate Among Critically Ill Patients. Frontiers In Neurology 2020, 11: 637. PMID: 32760341, PMCID: PMC7373742, DOI: 10.3389/fneur.2020.00637.Peer-Reviewed Original ResearchMedical ICU admissionIntensive care unitHeart rateIll patientsICU admissionCircadian alignmentMedical record chart abstractionsProspective observational cohort studyCircadian disruptionMedical ICU patientsObservational cohort studyCritical illness outcomesPilot observational studyContinuous telemetric monitoringChart abstractionExploratory analysisCohort studyCritical illnessHospital admissionICU patientsCare unitPatient interviewsFrequent bloodOdds ratioObservational study
2018
Non-circadian signals in the intensive care unit: Point prevalence morning, noon and night
Altman MT, Pulaski C, Mburu F, Pisani MA, Knauert MP. Non-circadian signals in the intensive care unit: Point prevalence morning, noon and night. Heart & Lung 2018, 47: 610-615. PMID: 30143362, PMCID: PMC6234066, DOI: 10.1016/j.hrtlng.2018.07.011.Peer-Reviewed Original ResearchConceptsSleep promotion interventionsIntensive care unitICU patient roomsQuality improvement initiativesCare unitSleep disturbancesObservational studyICU roomAbnormal lightPatient roomsSound exposureImprovement initiativesDoor curtainsInterventionPrevalenceEnvironmental factorsBright lightRoom doorICUFactorsSurvey of clinical pharmacist perceptions and practices in promoting sleep in intensive care unit patients
Heavner M, Nguyen N, Knauert M, Verceles A, Pisani M, Seung H, Gonzales J. Survey of clinical pharmacist perceptions and practices in promoting sleep in intensive care unit patients. JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2018, 2: 46-52. DOI: 10.1002/jac5.1027.Peer-Reviewed Original ResearchIntensive care unitICU patientsResults Two hundred fiftyIntensive care unit patientsSurgical intensive care unitProtocol usePharmacists' perceptionsCritical care pharmacistsCare unit patientsICU patient outcomesSignificant patient morbidityMelatonin receptor agonistCritical care practiceCross-sectional surveySleep protocolDelirium incidenceUnit patientsNighttime administrationCare unitPatient morbidityCare pharmacistsICU practiceReceptor agonistHundred fiftyPatient outcomesCreating Naptime
Knauert MP, Redeker NS, Yaggi HK, Bennick M, Pisani MA. Creating Naptime. Journal Of Patient Experience 2018, 5: 180-187. PMID: 30214923, PMCID: PMC6134539, DOI: 10.1177/2374373517747242.Peer-Reviewed Original ResearchIntensive care unitLaboratory drawsICU deliriumPromotion protocolRest periodDuration of deliriumMedical ICU patientsMedical chart reviewBrief clustersChart reviewICU patientsRoutine careCare unitSleep promotionPatient anxietyProtocol violationsSleep disruptionUrgent carePilot protocolOvernight rest periodPatient disturbancePatient careDeliriumStakeholder feedbackCare
2017
Factors Influencing Patients' Sleep in the Intensive Care Unit: Perceptions of Patients and Clinical Staff.
Ding Q, Redeker NS, Pisani MA, Yaggi HK, Knauert MP. Factors Influencing Patients' Sleep in the Intensive Care Unit: Perceptions of Patients and Clinical Staff. American Journal Of Critical Care 2017, 26: 278-286. PMID: 28668912, PMCID: PMC5559223, DOI: 10.4037/ajcc2017333.Peer-Reviewed Original ResearchConceptsIntensive care unitMedical intensive care unitPatients' sleepCare unitSleep improvementIntensive care unit staffIntensive care unit environmentPerceptions of patientsAdequate sleep opportunityIll patientsBeliefs of staffClinical outcomesSleep qualityRestorative sleepUnit staffPatientsClinical staffPatient surrogatesSleepUnit environmentSleep opportunityOnly factorPatients' emotionsNonenvironmental factorsSemistructured interviews
2016
Perceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers
Kamdar BB, Knauert MP, Jones SF, Parsons EC, Parthasarathy S, Pisani MA. Perceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers. Annals Of The American Thoracic Society 2016, 13: 1370-7. PMID: 27104770, PMCID: PMC5021080, DOI: 10.1513/annalsats.201601-087oc.Peer-Reviewed Original ResearchConceptsPoor sleepICU outcomesProviders' perceptionsIntensive care unit outcomesAvailable evidence-based guidelinesDevelopment of deliriumIntensive care unitEvidence-based guidelinesCritical care providersBetter sleep qualityMinority of providersICU surveyICU patientsIll patientsCare unitMechanical ventilationICU providersPatient outcomesRecent guidelinesPhysical therapyMost cliniciansPromotion protocolSleep qualityCare providersICUComparing average levels and peak occurrence of overnight sound in the medical intensive care unit on A-weighted and C-weighted decibel scales
Knauert M, Jeon S, Murphy TE, Yaggi HK, Pisani MA, Redeker NS. Comparing average levels and peak occurrence of overnight sound in the medical intensive care unit on A-weighted and C-weighted decibel scales. Journal Of Critical Care 2016, 36: 1-7. PMID: 27546739, PMCID: PMC5097003, DOI: 10.1016/j.jcrc.2016.06.005.Peer-Reviewed Original ResearchConceptsIntensive care unitMedical intensive care unitCare unitWorld Health Organization recommendationsProspective observational studyICU patient roomsIllness severityPatient factorsMechanical ventilationObservational studyPeak occurrenceICU environmentSignificant discordanceCircadian disruptionPatient roomsDecibel scaleSound levelsEquivalent sound levelPeak measuresDeliriumLevelsMeaningful factorsSleepLow-frequency soundAverage level
2015
Sleep Loss and Circadian Rhythm Disruption in the Intensive Care Unit
Knauert MP, Haspel JA, Pisani MA. Sleep Loss and Circadian Rhythm Disruption in the Intensive Care Unit. Clinics In Chest Medicine 2015, 36: 419-429. PMID: 26304279, DOI: 10.1016/j.ccm.2015.05.008.BooksConceptsCritical illnessSleep disruptionAppropriate administrative supportIntensive care unit environmentIntensive care unitCircadian rhythm disruptionDelirium reductionIll patientsCare unitPharmacologic interventionsSleep disturbancesRhythm disruptionCare deliveryMultidisciplinary strategyUnit environmentSleep lossIllnessDisruptionPatientsEffective strategySleepEnvironmental factors
2014
Feasibility study of unattended polysomnography in medical intensive care unit patients
Knauert MP, Yaggi HK, Redeker NS, Murphy TE, Araujo KL, Pisani MA. Feasibility study of unattended polysomnography in medical intensive care unit patients. Heart & Lung 2014, 43: 445-452. PMID: 25023504, PMCID: PMC4150840, DOI: 10.1016/j.hrtlng.2014.06.049.Peer-Reviewed Original ResearchConceptsMedical intensive care unitPortable polysomnographySleep efficiencyMedical intensive care unit patientsIntensive care unit patientsSleep deprivationOvernight sleep durationCare unit patientsObservational pilot studyIntensive care unitIndicators of feasibilityUnattended polysomnographyUnit patientsIll patientsPatients' sleepCare unitArousal indexPSG studiesSleep durationPatientsInterpretable qualityPilot studyGold standardSleepSleep stages