2017
DOI: 10.1177/1751143717692603
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The significance of circadian rhythms and dysrhythmias in critical illness

Abstract: Many physiological and cellular processes cycle with time, with the period between one peak and the next being roughly equal to 24 h. These circadian rhythms underlie 'permissive homeostasis', whereby anticipation of periods of increased energy demand or stress may enhance the function of individual cells, organ systems or whole organisms. Many physiological variables related to survival during critical illness have a circadian rhythm, including the sleep/wake cycle, haemodynamic and respiratory indices, immun… Show more

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Cited by 43 publications
(53 citation statements)
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References 79 publications
(95 reference statements)
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“…Our protocol included a large number of patients, as compared to previous studies [21,28,37,42,43]. Temperature measurements were collected from a central site-this point being the most common limitation encountered in other studies [21,28,37,40,44]. Bladder temperature monitoring is a validated method for determining CBT-with a minimal error margin and a good correlation with CBT [45].…”
Section: Discussionmentioning
confidence: 99%
“…Our protocol included a large number of patients, as compared to previous studies [21,28,37,42,43]. Temperature measurements were collected from a central site-this point being the most common limitation encountered in other studies [21,28,37,40,44]. Bladder temperature monitoring is a validated method for determining CBT-with a minimal error margin and a good correlation with CBT [45].…”
Section: Discussionmentioning
confidence: 99%
“…These parameters are continuously measured and monitored during the normal course of operation of most ICUs and are used as predictors of mortality rates in patients in ICUs. Their 24‐h rhythm can be altered by the influence of light (Bourcier et al, ; McKenna et al, ). This study investigated the potential role differential exposure to natural light in an ICU setting may play.…”
Section: Aims and Objectives Of The Studymentioning
confidence: 99%
“…The internal states of patients in an intensive care unit (ICU), because of medication (sedation, opioids) and physiological parameters (organ dysfunction and failure), tend to result in distorted 24‐h rhythms (Paul and Lemmer, ; McKenna et al, ). On the other hand, external cycles (light, environmental noise, medical and nursing interventions) tend towards 24‐h activity (Weiss et al, ; Korompeli et al, ; McKenna et al, ). Artificial lighting afforded to patients, however, only loosely conforms to ‘normal’ light/dark cycles, and nursing rosters are structured to respond to staff availability and capability.…”
Section: Introductionmentioning
confidence: 99%
“…Both illness and the hospital environment itself disrupt the usual 24 hour cycles that govern human behaviour (such as sleeping, waking, eating and physical activity), physiological indices (temperature, heart rate, urine output) and intracellular processes (gene expression, enzyme activity and mitochondrial function) 9 . The circadian oscillation in these diverse functions is synchronised to the time of day, through the light-dark cycle and other cues such as regular feeding times.…”
Section: Introductionmentioning
confidence: 99%