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Night shift decreases cognitive performance of ICU physicians

Intensive Care Medicine volume 42, pages 393–400 (2016)Cite this article

Abstract

Background

The relationship between tiredness and the risk of medical errors is now commonly accepted. The main objective of this study was to assess the impact of an intensive care unit (ICU) night shift on the cognitive performance of a group of intensivists. The influence of professional experience and the amount of sleep on cognitive performance was also investigated.

Methods

A total of 51 intensivists from three ICUs (24 seniors and 27 residents) were included. The study participants were evaluated after a night of rest and after a night shift according to a randomized order. Four cognitive skills were tested according to the Wechsler Adult Intelligence Scale and the Wisconsin Card Sorting Test.

Results

All cognitive abilities worsened after a night shift: working memory capacity (11.3 ± 0.3 vs. 9.4 ± 0.3; p < 0.001), speed of processing information (13.5 ± 0.4 vs. 10.9 ± 0.3; p < 0.001), perceptual reasoning (10.6 ± 0.3 vs. 9.3 ± 0.3; p < 0.002), and cognitive flexibility (41.2 ± 1.2 vs. 44.2 ± 1.3; p = 0.063). There was no significant difference in terms of level of cognitive impairment between the residents and ICU physicians. Only cognitive flexibility appeared to be restored after 2 h of sleep. The other three cognitive skills were altered, regardless of the amount of sleep during the night shift.

Conclusions

The cognitive abilities of intensivists were significantly altered following a night shift in the ICU, regardless of either the amount of professional experience or the duration of sleep during the shift. The consequences for patients’ safety and physicians’ health should be further evaluated.

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Acknowledgments

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Author information

Authors and Affiliations

  1. Assistance Publique, Hôpitaux de Marseille, Hôpital Nord, Réanimation des Détresses Respiratoires et des Infections Sévères, Chemin des Bourrely, 13015, Marseille, France

    François Maltese, Mélanie Adda, Amandine Bablon, Sami Hraeich, Christophe Guervilly, Samuel Lehingue, Jean-Marie Forel & Laurent Papazian

  2. Faculté de médecine, Aix-Marseille Université, URMITE UMR CNRS 7278, 13005, Marseille, France

    Sami Hraeich, Samuel Lehingue, Marc Leone, Claude Martin, Antoine Roch & Laurent Papazian

  3. Assistance Publique, Hôpitaux de Marseille, Hôpital de la Conception, Service d’Anesthésie-Réanimation, 13005, Marseille, France

    Sandrine Wiramus

  4. Assistance Publique, Hôpitaux de Marseille, Hôpital Nord, Service d’Anesthésie-Réanimation, 13015, Marseille, France

    Marc Leone, Claude Martin & Renaud Vialet

  5. Assistance Publique, Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Service de Santé Publique et de l’Information Médicale, 13009, Marseille, France

    Xavier Thirion

  6. Assistance Publique, Hôpitaux de Marseille, Hôpital Nord, Service d’accueil des Urgences, 13015, Marseille, France

    Antoine Roch

Authors
  1. François Maltese
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  2. Mélanie Adda
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  3. Amandine Bablon
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  4. Sami Hraeich
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  5. Christophe Guervilly
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  6. Samuel Lehingue
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  7. Sandrine Wiramus
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  8. Marc Leone
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  9. Claude Martin
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  10. Renaud Vialet
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  11. Xavier Thirion
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  12. Antoine Roch
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  13. Jean-Marie Forel
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  14. Laurent Papazian
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Corresponding author

Correspondence to Laurent Papazian.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Additional information

This work was performed at the Réanimation des Détresses Respiratoires et des Infections Sévères Intensive Care Unit, the Surgical Intensive Care Unit and the Paediatric Intensive Care Unit of the Hôpital Nord, Assistance Publique, Hôpitaux de Marseille (Marseille, France).

Take-home message: Residents and staff physicians from three ICUs were studied after a night of rest and after a night shift. Four key areas of cognitive ability were decreased after a night shift.

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Cite this article

Maltese, F., Adda, M., Bablon, A. et al. Night shift decreases cognitive performance of ICU physicians. Intensive Care Med 42, 393–400 (2016). https://doi.org/10.1007/s00134-015-4115-4

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  • DOI: https://doi.org/10.1007/s00134-015-4115-4

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