Cycled light in the intensive care unit for preterm and low birth weight infants

Morag, Iris; Ohlsson, Arne

doi:10.1002/14651858.cd006982.pub4

Cited by 57 publications

(21 citation statements)

References 59 publications

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“…Evidence on several clinically important topics includes no RCTs sponsored by industry. Topics such as assessing head elevation for severe brain injury [ 36 ], music to calm mechanically ventilated patients [ 37 ], cycled lights in neonatal intensive care units [ 38 ], or cough augmentation techniques for extubation [ 39 ] are procedures where the lack of industry funding is easily explained. Such procedures do not necessarily involve equipment or products manufactured by the biopharmaceutical, biotechnology, or other health-related industry.…”

Section: Discussionmentioning

confidence: 99%

Industry-funded versus non-profit-funded critical care research: a meta-epidemiological overview

2018

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PurposeTo study the landscape of funding in intensive care research and assess whether the reported outcomes of industry-funded randomized controlled trials (RCTs) are more favorable.MethodsWe systematically assembled meta-analyses evaluating any type of intervention in the critical care setting and reporting the source of funding for each included RCT. Furthermore, when the intervention was a drug or biologic, we searched also the original RCT articles, when their funding information was unavailable in the meta-analysis. We then qualitatively summarized the sources of funding. For binary outcomes, separate summary odds ratios were calculated for trials with and without industry funding. We then calculated the ratio of odds ratios (RORs) and the summary ROR (sROR) across topics. ROR < 1 implies that the experimental intervention is relatively more favorable in trials with industry funding compared with trials without industry funding. For RCTs included in the ROR analysis, we also examined the conclusions of their abstract.ResultsAcross 67 topics with 568 RCTs, 88 were funded by industry and another 73 had both industry and non-profit funding. Across 33 topics with binary outcomes, the sROR was 1.10 [95% CI (0.96–1.26), I2 = 1%]. Conclusions were not significantly more commonly unfavorable for the experimental arm interventions in industry-funded trials (21.3%) compared with trials without industry funding (18.2%).ConclusionIndustry-funded RCTs are the minority in intensive care. We found no evidence that industry-funded trials in intensive care yield more favorable results or are less likely to reach unfavorable conclusions.Electronic supplementary materialThe online version of this article (10.1007/s00134-018-5325-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Industry-funded versus non-profit-funded critical care research: a meta-epidemiological overview

2018

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“…Therefore, it should be perhaps no surprise that several studies on preterm infants revealed that imposing a rhythm to the NICU lighting conditions exerts beneficial acute effects, e.g. faster weight gain and recovery, shorter hospitalization [91][92][93][94][95]. Some benefits were found to be stronger than others, but all were encouraging.…”

Section: Neonatal Units and White Matter Injurymentioning

confidence: 97%

Potential Circadian Rhythms in Oligodendrocytes? Working Together Through Time

Colwell

2019

Neurochem Res

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Oligodendrocytes (OL) are the only myelinating cells of the central nervous system thus interferences, either environmental or genetic, with their maturation or function have devastating consequences. Albeit so far neglected, one of the less appreciated, nevertheless possible, regulators of OL maturation and function is the circadian cycle. Yet, disruptions in these rhythms are unfortunately becoming a common "disorder" in the today's world. The temporal patterning of behaviour and physiology is controlled by a circadian timing system based in the anterior hypothalamus. At the molecular level, circadian rhythms are generated by a transcriptional/translational feedback system that regulates transcription and has a major impact on cellular function(s). Fundamental cellular properties/functions in most cell types vary with the daily circadian cycle: OL are unlikely an exception! To be clear, the presence of circadian oscillators or the cell-specific function(s) of the circadian clock in OL has yet to be defined. Furthermore, we wish to entertain the idea of links between the "thin" evidence on OL intrinsic circadian rhythms and their interjection(s) at different stages of lineage progression as well as in supporting/regulating OL crucial function: myelination. Individuals with intellectual and developmental syndromes as well as neurodegenerative diseases present with a disrupted sleep/wake cycle; hence, we raise the possibility that these disturbances in timing can contribute to the loss of white matter observed in these disorders. Preclinical and clinical work in this area is needed for a better understanding of how circadian rhythms influence OL maturation and function(s), to aid the development of new therapeutic strategies and standards of care for these patients.

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“…Introducing a robust light-dark cycle in the NICU has been suggested as a strategy to entrain the circadian system in preterm infants, which may support growth and development as well as help prevent complications frequently experienced by the preterm infant such as disturbances in body temperature, sleep or feeding patterns ( Morag and Ohlsson, 2016 ). Currently, lighting conditions in NICUs across the world are highly variable, owing to flexible guidelines (e.g., see Best et al, 2018 ).…”

Section: Circadian Entrainment By Light-dark Cycles In the Neonatal Imentioning

confidence: 99%

“…For example, the Consensus Committee for NICU Design, recommends illuminance levels to be between 10 and 600 lux in the NICU ( White et al, 2013 ). NICUs can be distinguished by observing either constant light or constant near-darkness, with light levels below 20 lux throughout the 24-h period ( Morag and Ohlsson, 2016 ).…”

Section: Circadian Entrainment By Light-dark Cycles In the Neonatal Imentioning

confidence: 99%

“…Several studies have evaluated the effect of introducing a robust light-dark cycle (‘cycled light’) compared to either constant light or near-darkness on clinical outcomes in preterm infants in NICUs, such as weight gain. A systematic review by the Cochrane library concluded that cycled light seems to shorten the length of hospital stay, although the evidence is hampered by the small sample size and the inability to blind the intervention ( Morag and Ohlsson, 2016 ). Cycled light may also improve other outcomes, such as weight gain and the incidence or retinopathy of prematurity ( Morag and Ohlsson, 2016 ).…”

Section: Circadian Entrainment By Light-dark Cycles In the Neonatal Imentioning

confidence: 99%

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Beginning to See the Light: Lessons Learned From the Development of the Circadian System for Optimizing Light Conditions in the Neonatal Intensive Care Unit

et al. 2021

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The circadian timing system optimizes health by temporally coordinating behavior and physiology. During mammalian gestation, fetal circadian rhythms are synchronized by the daily fluctuations in maternal body temperature, hormones and nutrients. Circadian disruption during pregnancy is associated with negative effects on developmental outcomes in the offspring, highlighting the importance of regular and robust 24-h rhythms over gestation. In the case of preterm birth (before 37 weeks of gestation), maternal cues no longer synchronize the neonate’s circadian system, which may adversely affect the neonate. There is increasing evidence that introducing robust light-dark cycles in the Neonatal Intensive Care Unit has beneficial effects on clinical outcomes in preterm infants, such as weight gain and hospitalization time, compared to infants exposed to constant light or constant near-darkness. However, the biological basis for these effects and the relationship with the functional and anatomical development of the circadian system is not fully understood. In this review, we provide a concise overview of the effects of light-dark cycles on clinical outcomes of preterm neonates in the NICU and its alignment with the development of the circadian system.

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Cycled light in the intensive care unit for preterm and low birth weight infants

Cited by 57 publications

References 59 publications

Industry-funded versus non-profit-funded critical care research: a meta-epidemiological overview

Industry-funded versus non-profit-funded critical care research: a meta-epidemiological overview

Potential Circadian Rhythms in Oligodendrocytes? Working Together Through Time

Beginning to See the Light: Lessons Learned From the Development of the Circadian System for Optimizing Light Conditions in the Neonatal Intensive Care Unit

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