Jingjing Li, Shining Cai, Xiao Liu, Jinghua Mei, Wenyan Pan, Joseph M Latour, Ming Zhong, Yuxia Zhang
{"title":"ICU患者褪黑激素分泌的昼夜节律及相关因素:一项前瞻性队列研究","authors":"Jingjing Li, Shining Cai, Xiao Liu, Jinghua Mei, Wenyan Pan, Joseph M Latour, Ming Zhong, Yuxia Zhang","doi":"10.1080/07420528.2025.2552861","DOIUrl":null,"url":null,"abstract":"<p><p>Circadian rhythm of melatonin secretion disturbance is common in patients in the intensive care unit (ICU) and may contribute to poor patient prognoses. The aim of this study was to explore the melatonin secretion rhythm in critically ill patients and to identify factors influencing the melatonin secretion rhythm. This was a prospective cohort study conducted in the surgical ICU of a tertiary hospital in Shanghai, China, between February 2022 and December 2022. Patients were enrolled if they were conscious, > 18years, had an expected ICU stay longer than 24 h, and were postoperative. Patient observations started on the first day of admission. ICU light and noise level, baseline characteristics, average night-time interruptions, pain level, use of analgesics and sedation, feeding, duration of mechanical ventilation, leukocyte and procalcitonin (PCT) level, surgical procedures and disease information were observed. We defined melatonin rhythmicity by calculating melatonin acrophase and amplitude. Serum melatonin was collected at 3:00, 8:00, and 16:00 on the first three days after admission. There were 190 ICU patients included in this study. The melatonin acrophase was abnormal in 100 (52.6%) patients. Use of analgesics (<i>p</i> = 0.002) and average night-time interruptions (<i>p</i> = 0.011) were independently related to the melatonin acrophase. Melatonin amplitude was associated with age and average night-time interruptions (<i>p</i> = 0.018 and <i>p</i> = 0.048, respectively). Clinical staff should routinely assess patients' pain levels using validated assessment tools and implement a combination of non-pharmacological and pharmacological pain control interventions. To optimize the ICU environment at night, non-urgent medical procedures should be limited to only those necessary. These approaches may help ICU patients maintain their circadian rhythm and potentially improve their overall recovery.</p>","PeriodicalId":10294,"journal":{"name":"Chronobiology International","volume":" ","pages":"1-11"},"PeriodicalIF":1.7000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Circadian rhythm of melatonin secretion and associated factors of patients in the ICU: A prospective cohort study.\",\"authors\":\"Jingjing Li, Shining Cai, Xiao Liu, Jinghua Mei, Wenyan Pan, Joseph M Latour, Ming Zhong, Yuxia Zhang\",\"doi\":\"10.1080/07420528.2025.2552861\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Circadian rhythm of melatonin secretion disturbance is common in patients in the intensive care unit (ICU) and may contribute to poor patient prognoses. The aim of this study was to explore the melatonin secretion rhythm in critically ill patients and to identify factors influencing the melatonin secretion rhythm. This was a prospective cohort study conducted in the surgical ICU of a tertiary hospital in Shanghai, China, between February 2022 and December 2022. Patients were enrolled if they were conscious, > 18years, had an expected ICU stay longer than 24 h, and were postoperative. Patient observations started on the first day of admission. ICU light and noise level, baseline characteristics, average night-time interruptions, pain level, use of analgesics and sedation, feeding, duration of mechanical ventilation, leukocyte and procalcitonin (PCT) level, surgical procedures and disease information were observed. We defined melatonin rhythmicity by calculating melatonin acrophase and amplitude. Serum melatonin was collected at 3:00, 8:00, and 16:00 on the first three days after admission. There were 190 ICU patients included in this study. The melatonin acrophase was abnormal in 100 (52.6%) patients. Use of analgesics (<i>p</i> = 0.002) and average night-time interruptions (<i>p</i> = 0.011) were independently related to the melatonin acrophase. Melatonin amplitude was associated with age and average night-time interruptions (<i>p</i> = 0.018 and <i>p</i> = 0.048, respectively). Clinical staff should routinely assess patients' pain levels using validated assessment tools and implement a combination of non-pharmacological and pharmacological pain control interventions. To optimize the ICU environment at night, non-urgent medical procedures should be limited to only those necessary. These approaches may help ICU patients maintain their circadian rhythm and potentially improve their overall recovery.</p>\",\"PeriodicalId\":10294,\"journal\":{\"name\":\"Chronobiology International\",\"volume\":\" \",\"pages\":\"1-11\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Chronobiology International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/07420528.2025.2552861\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chronobiology International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/07420528.2025.2552861","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOLOGY","Score":null,"Total":0}
Circadian rhythm of melatonin secretion and associated factors of patients in the ICU: A prospective cohort study.
Circadian rhythm of melatonin secretion disturbance is common in patients in the intensive care unit (ICU) and may contribute to poor patient prognoses. The aim of this study was to explore the melatonin secretion rhythm in critically ill patients and to identify factors influencing the melatonin secretion rhythm. This was a prospective cohort study conducted in the surgical ICU of a tertiary hospital in Shanghai, China, between February 2022 and December 2022. Patients were enrolled if they were conscious, > 18years, had an expected ICU stay longer than 24 h, and were postoperative. Patient observations started on the first day of admission. ICU light and noise level, baseline characteristics, average night-time interruptions, pain level, use of analgesics and sedation, feeding, duration of mechanical ventilation, leukocyte and procalcitonin (PCT) level, surgical procedures and disease information were observed. We defined melatonin rhythmicity by calculating melatonin acrophase and amplitude. Serum melatonin was collected at 3:00, 8:00, and 16:00 on the first three days after admission. There were 190 ICU patients included in this study. The melatonin acrophase was abnormal in 100 (52.6%) patients. Use of analgesics (p = 0.002) and average night-time interruptions (p = 0.011) were independently related to the melatonin acrophase. Melatonin amplitude was associated with age and average night-time interruptions (p = 0.018 and p = 0.048, respectively). Clinical staff should routinely assess patients' pain levels using validated assessment tools and implement a combination of non-pharmacological and pharmacological pain control interventions. To optimize the ICU environment at night, non-urgent medical procedures should be limited to only those necessary. These approaches may help ICU patients maintain their circadian rhythm and potentially improve their overall recovery.
期刊介绍:
Chronobiology International is the journal of biological and medical rhythm research. It is a transdisciplinary journal focusing on biological rhythm phenomena of all life forms. The journal publishes groundbreaking articles plus authoritative review papers, short communications of work in progress, case studies, and letters to the editor, for example, on genetic and molecular mechanisms of insect, animal and human biological timekeeping, including melatonin and pineal gland rhythms. It also publishes applied topics, for example, shiftwork, chronotypes, and associated personality traits; chronobiology and chronotherapy of sleep, cardiovascular, pulmonary, psychiatric, and other medical conditions. Articles in the journal pertain to basic and applied chronobiology, and to methods, statistics, and instrumentation for biological rhythm study.
Read More: http://informahealthcare.com/page/cbi/Description