Objective:
The stress level of participants in high-fidelity simulation stems from various factors but may result in anticipatory anxiety causing sleep disturbances during the night prior to simulation. The objective of this survey was to determine the change in sleep quality of residents during the night prior to the simulation.
Methods:
The survey was proposed for 1 year to all residents at the beginning of the simulation, in 10 simulation centres. The questionnaire combined demographics and the Leeds Sleep Evaluation Questionnaire using visual analogue scales divided into 4 sleep qualitative domains. The primary outcome was the prevalence of sleep disturbance (>10 mm on 1 domain). Secondary outcomes were the prevalence of severe sleep disturbance (>25 mm), as well as qualitatively and quantitatively reported explanatory sleep parameters.
Results:
Among respondents, 66% [95% CI: 63 to 69] of residents had more than 10 mm and 27% [95% CI: 24 to 30] had more than 25 mm of sleep disturbance. Residents with a sleep disturbance of more than 10 mm had fewer hours of sleep (6.4 [standard deviation = 1.8] vs 7.3 [standard deviation = 1.3], difference: −0.9 [95% CI: −1.1 to −0.7];
P
< .0001), with a higher number of night-time awakenings (1.3 [standard deviation = 1.5] vs 0.7 [standard deviation = 0.9], difference: 0.6 [95% CI: 0.4 to 0.8];
P
< .0001).
Conclusion:
Among residents participating in the simulation, a high prevalence of change in sleep quality during the night before the simulation was noted. Strategies to help residents achieve better sleep prior to simulation should be explored.
Le choc septique est fréquent et représente la première cause de mortalité en réanimation. Malgré des recommandations internationales mises à jour régulièrement (Surviving Sepsis Campaign) et les progrès de la réanimation, la mortalité reste très élevée (jusqu’à 40%), en partie du fait des conséquences d’une réponse immuno-inflammatoire de l’hôte « dérégulée ». Le rationnel physiopathologique des techniques extra-corporelles d’immunomodulation dans le choc septique repose sur un meilleur contrôle de cette réponse de l’hôte. De nombreuses techniques sont proposées, certaines combinant l’élimination des cytokines et/ou des endotoxines avec l’épuration extra-rénale. La littérature scientifique est relativement abondante à ce sujet. Les grands essais cliniques multicentriques récents ne confirment pas les résultats expérimentaux et précliniques prometteurs. La recherche expérimentale et clinique doit se poursuivre dans ce domaine. Nous proposons dans cet article une revue de la littérature des différentes techniques extracorporelles d’immunomodulation dans le choc septique.
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