The effectiveness of noise interventions in the ICU

The effectiveness of noise interventions in the ICU

Purpose of review
Excessive noise has direct adverse physiological and psychological effects, and may also have indirect
negative health consequences by reducing sleep quality and quantity. This review presents a synthesis of
the epidemiology of noise in the ICU, and the potential interventions designed to attenuate noise and
protect patients.
Recent findings
Noise increases cortisol release, oxygen consumption, and vasoconstriction. ICU noise levels are excessive
throughout the 24-h cycle, irrespective of level of intervention or whether the patient is in a side room or
open ward. Direct measurement suggests that noise is a substantial contributor to poor sleep quantity and
quality in the ICU and is frequently recalled by survivors of critical illness as a negative experience of ICU
admission. Noise abatement, environmental masking and pharmacological interventions may all reduce the
impact of noise on patients. However, the sustainability of behavioural interventions remains uncertain and
high-quality evidence demonstrating the benefit of any intervention on patient-centered outcomes is lacking.
Summary
Noise levels in the ICU are consistently reported to reach levels likely to have both direct and indirect
adverse health consequences for both patients and staff. Noise reduction, abating the transmission of noise
and pharmacological modulation of the adverse neural effects of noise are all potentially beneficial
strategies, although definitive evidence of improved patient-centered outcomes is lacking.