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Background: In critically ill patients, a poor sleep quality can escalate mortality and the length of hospital stays. Albeit being the gold standard for sleep assessment, polysomnography (PSG) is expensive and complicated. The Richards‐Campbell sleep questionnaire (RCSQ) is another tool with proof of good correlation with PSG. RCSQ was translated into many languages. However, the Thai version (T‐RCSQ) has not been developed. Aims and objectives: Our study aimed to translate the original RCSQ into Thai, to test the content validity and reliability, and to introduce the questionnaire into clinical practice at the surgical intensive care unit (SICU). Design: Prospective cross‐sectional study Methods: This study enrolled 92 patients from the SICU between August 2019 and January 2020. The content validity of T‐RCSQ was determined by the index of item‐objective congruence (IOC). The reliability was tested by test‐retest reliability at 7 am and 9 am after intensive care unit (ICU) admission. The internal consistency was expressed by Cronbach's alpha. Patients' demography was reported as percentage, mean and standard deviation, and median and interquartile range. Results: The content validity and test‐retest reliability of the T‐RCSQ were 0.8 and 0.97, respectively. The internal consistency was 0.964. Most patients were female with American Society of Anesthesiologist physical status III. The mean RCSQ scores at 7 am and 9 am were 5.82 ± 2.15 cm and 5.61 ± 2.18 cm, respectively. Conclusions: The T‐RCSQ is reliable and could be used as an alternative to PSG for sleep assessment of ICU patients. Further research is required to validate the T‐RCSQ against PSG and to assess its impact on improving sleep quality and patients' clinical outcomes. Relevance to clinical practice: T‐RCSQ is a useful tool for sleep assessment in ICU. According to cost‐effectiveness, convenience, and good reliability, it could be applied to determine proper sleep to minimize patient morbidity and mortality. [ABSTRACT FROM AUTHOR]

Objective: Airway complications in obese patients are a major concern during surgical operation. This study aimed to determine the incidence of airway- and respiratory-related anesthetic complications for obese (including maternal) patients undergoing general anesthesia. Materials and Methods: This multicenter, retrospective, observational study evaluated obese female patients (BMI ≥ 30 kg/m2), both non-pregnant and pregnant, undergoing general anesthesia in 5 hospitals across Thailand during May 2013 - August 2016. The primary observation was anesthesia-related airway complications (difficult and failed intubations, aspiration, desaturation, and airway injuries) detected during anesthesia. An analysis was performed to compare the incidents of the adverse events and to determine the risk factors for airway-related adverse events in both groups. Results: There were 1,347 obese patients enrolled (777 non-pregnant and 570 pregnant). The overall incidence of airway and respiratory complications was observed in 129 patients (9.6%), with a higher rate in pregnant patients (12.5% vs. 7.5%; p<0.05). The most common complications were desaturation (5.6%) followed by airway injuries (3.6%) and difficult intubation (1.5%). The factors significantly associated with adverse airway-related events were obesity class II (OR=1.63 [1.05-2.54]), obesity class III (OR=2.25 [1.19-4.25]), pregnancy (OR=1.73 [1.18-2.54]), Mallampati classifications III-IV (OR=1.69 [1.16-2.48]), and neck circumference <43 cm (OR=3.33 [1.02-10.81]), p<0.05). Conclusion: The incidence of the anesthesia-related airway and respiratory complications was 9.6%, with a higher rate in pregnant patients. The most common adverse airway event was desaturation. However, the frequency of serious airway events was low. [ABSTRACT FROM AUTHOR]

Background: A common postoperative complication found among patients who are critically ill is delirium, which has a high mortality rate. A predictive model is needed to identify high-risk patients in order to apply strategies which will prevent and/or reduce adverse outcomes. Objectives: To identify the incidence of, and the risk factors for, postoperative delirium (POD) in surgical intensive care unit (SICU) patients, and to determine predictive scores for the development of POD. Methods: This study enrolled adults aged over 18 years who had undergone an operation within the preceding week and who had been admitted to a SICU for a period that was expected to be longer than 24 h. The CAM − ICU score was used to determine the occurrence of delirium. Results: Of the 250 patients enrolled, delirium was found in 61 (24.4%). The independent risk factors for delirium that were identified by a multivariate analysis comprised age, diabetes mellitus, severity of disease (SOFA score), perioperative use of benzodiazepine, and mechanical ventilation. A predictive score (age + (5 × SOFA) + (15 × Benzodiazepine use) + (20 × DM) + (20 × mechanical ventilation) + (20 × modified IQCODE > 3.42)) was created. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.84 (95% CI: 0.786 to 0.897). The cut point of 125 demonstrated a sensitivity of 72.13% and a specificity of 80.95%, and the hospital mortality rate was significantly greater among the delirious than the non-delirious patients (25% vs. 6%, p < 0.01). Conclusions: POD was experienced postoperatively by a quarter of the surgical patients who were critically ill. A risk score utilizing 6 variables was able to predict which patients would develop POD. The identification of high-risk patients following SICU admission can provide a basis for intervention strategies to improve outcomes. Trial registration: Thai Clinical Trials Registry TCTR20181204006. Date registered on December 4, 2018. Retrospectively registered. [ABSTRACT FROM AUTHOR]