Konzepte zur Reduktion der Lärmbelastung auf der Intensivstation

Zusammenfassung

Die Lärmbelastung auf der Intensivstation ist ein allgegenwärtiges, erhebliches Problem für Patienten und Personal. Viele maßgebliche Lärmquellen sind mitverantwortlich für die häufigen Schlafstörungen der Patienten, die das Auftreten eines Delirs begünstigen. Der Beitrag fasst die aktuelle Evidenz zur Entstehung lärmassoziierter Auswirkungen zusammen und zeigt Optionen zur Lärmreduktion und Verbesserung der Therapie von Intensivpatienten auf.

Abstract

Noise pollution in the intensive care unit is not only an omnipresent but also a considerable problem, both for patients and healthcare staff. There are a number of significant sources of noise that are at least partially responsible for the frequent and serious sleep disorders of intensive care unit patients. This has a negative impact on the recovery of intensive care patients and favours the occurrence of delirium, which can be associated with increased overall mortality. This article provides a summary of the current evidence on the occurrence of noise-associated consequences and possible options for reducing noise exposure in the intensive care unit and offers perspectives for improving treatment of intensive care patients.

Kernaussagen

• Lärm zählt zu den häufigsten den Schlaf störenden Faktoren bei kritisch kranken Patienten.

• Lärm ist ein modifizierbarer Risikofaktor für Schlafstörungen, Störungen des zirkadianen Rhythmus und die Entwicklung eines Delirs.

• Alarme und mit dem Intensivstationspersonal zusammenhängende Tätigkeiten, insbesondere jedoch Gesprächsereignisse und Unterhaltungen, werden am meisten mit der Lärmentstehung auf der Intensivstation in Zusammenhang gebracht.

• Obwohl der kausale Zusammenhang zwischen Lärmreduktion und der Verbesserung relevanter Outcome-Parameter gegenwärtig nicht zweifelsfrei bewiesen ist, legen die bisher vorliegenden Untersuchungen nahe, dass

  • Maßnahmen zur Reduktion der Lärmentstehung durch Verhaltensänderung den Lärmpegel auf der Intensivstation reduzieren können und

  • Maßnahmen zur Reduktion der Schallübertragung die subjektive Schlafqualität verbessern und die Delirinzidenz senken können.

• Eine nächtliche medikamentöse Sedierung verschlechtert die ohnehin schon eingeschränkte Schlafqualität durch Reduktion der REM- und SWS-Phasen weiter.

Schlüsselwörter

Lärm - Schlaf - Delir - Ruhezeit-Episoden - Verhaltensänderung

Key words

noise - sleep - delirium - quiet time periods - behaviour modification

Publikationsverlauf

Artikel online veröffentlicht:
08. September 2022

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