Sleep in the Intensive Care Unit: Biological, Environmental, and Pharmacologic Implications for Nurses.

There is a clear relationship between lack of sleep, poor health outcomes, and delayed recovery from illness in the intensive care unit. Several factors can contribute to poor quality sleep in the intensive care unit, including (1) environmental disruptions such as light and sound, (2) physiologic disruptions such as discomfort, nausea, and pain, (3) psychological disruptions such as anxiety and a lack of privacy, and (4) health care provider-related disruptions, such as medication administration and nursing care. Nursing implications include increased attention to the role of sleep to promote intensive care unit patient's health outcomes and using multicomponent sleep-promoting protocols.

Critical Update on the Third Edition of the Guidelines for Managing Severe Traumatic Brain Injury in Children.

Background: Severe traumatic brain injury (TBI) is associated with high rates of death and disability. As a result, the revised guidelines for the management of pediatric severe TBI address some of the previous gaps in pediatric TBI evidence and management strategies targeted to promote overall health outcomes.

Objectives: To provide highlights of the most important updates featured in the third edition of the guidelines for the management of pediatric severe TBI.