The effect of melatonin on reduction in the need for sedative agents and duration of mechanical ventilation in traumatic intracranial hemorrhage patients: a randomized controlled trial

Abstract

Purpose This study aimed to determine the effect of exogenous melatonin on the number of sedative drugs and the duration of mechanical ventilation in traumatic intracranial hemorrhage patients in ICU. Methods This double-blind randomized clinical trial study was conducted in the ICU wards of Golestan Hospital, Ahvaz, Iran, from September 2017 to March 2018. In this study, 52 patients with intracerebral hemorrhage were selected by convenient sampling (26 patients in each group) and were randomly assigned to two groups of melatonin and control. Sedation and pain management package was applied to both groups. Outcomes: Amount of the sedative and opioid drug; mechanical ventilation time; ICU staying time; Glasgow Coma Score; hemodynamic parameters. Results There was no significant difference between them in terms of demographic characteristics. Cumulative doses of morphine and mechanical ventilation time were significant in two groups. ( P < 0.05) The mean length of ICU staying was not significant. Glasgow Coma Score on the 6th day was significant in two groups ( P < 0.05). Diastolic blood pressure was significant between groups ( P < 0.001). Conclusion This study presented that morphine consumption and mechanical ventilation time were significantly lower in the melatonin group than in the control. Also, rise in GCS in the melatonin group was faster in the melatonin group than in the control. The use of melatonin can be recommended for patients with ICH in the ICU for better outcomes.

The use of melatonin in Danish intensive care departments—A nationwide observational study

“…Doses have ranged up to 30 mg 16 . Sleep was assessed by questionnaires and indirect objective measures of sleep 16–22 . Sleep quality and patient‐related outcomes, such as length of stay and the amount of administered sedatives, seemed to improve in patients treated with melatonin 16–23 .…”

“…Doses have ranged up to 30 mg. 16 Sleep was assessed by questionnaires and indirect objective measures of sleep. [16][17][18][19][20][21][22] Sleep quality and patient-related outcomes, such as length of stay and the amount of administered sedatives, seemed to improve in patients treated with melatonin. [16][17][18][19][20][21][22][23] A recent Cochrane review evaluated the literature concerning melatonin therapy in the ICU.…”

“…[16][17][18][19][20][21][22] Sleep quality and patient-related outcomes, such as length of stay and the amount of administered sedatives, seemed to improve in patients treated with melatonin. [16][17][18][19][20][21][22][23] A recent Cochrane review evaluated the literature concerning melatonin therapy in the ICU. 9 The authors concluded that the use of melatonin in this patient group could not be advocated at this moment due to a low methodological quality and heterogeneity of included studies.…”

Could Melatonin Be an Alternative to Benzodiazepine for Chronic Obstructive Pulmonary Disease With Insomnia?

“…A recent study showed that melatonin reduced the sedative use and the duration of mechanical ventilation for patients with intracerebral hemorrhage in the ICU [108]. The results indicated that the mechanical ventilation time and cumulative doses of morphine were significantly lower in the group treated with melatonin [108]. Hyposecretion of melatonin during mechanical ventilation and disturbed diurnal rhythm has been observed in most patients treated in the ICU [109].…”

Efficacy of melatonin in non-intensive care unit patients with COVID-19 pneumonia and sleep dysregulation

“…Several studies implicate endogenous melatonin in the physiological regulation of the circadian mechanisms ruling sleep propensity (33). Melatonin reduces the need for sedation in ICU patients (34)(35)(36)(37)(38)(39). Thus, in the context of COVID-19 pandemic the therapeutical utility of melatonin emerges.…”