دورية أكاديمية
Circadian rhythm in critically ill patients: Insights from the eICU Database.
| العنوان: | Circadian rhythm in critically ill patients: Insights from the eICU Database. |
|---|---|
| المؤلفون: | Beyer SE; Division of Cardiology, Department of Medicine, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York., Salgado C; IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal., Garçao I; IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal., Celi LA; Laboratory of Computational Physiology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts.; Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts., Vieira S; IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal. |
| المصدر: | Cardiovascular digital health journal [Cardiovasc Digit Health J] 2021 Feb 17; Vol. 2 (2), pp. 118-125. Date of Electronic Publication: 2021 Feb 17 (Print Publication: 2021). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101771268 Publication Model: eCollection Cited Medium: Internet ISSN: 2666-6936 (Electronic) Linking ISSN: 26666936 NLM ISO Abbreviation: Cardiovasc Digit Health J Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York] : Elsevier Inc., [2020]- |
| مستخلص: | Objective: To investigate the circadian variation among critically ill patients and its association with clinical characteristics and survival to hospital discharge in a large population of patients in the intensive care unit (ICU). Methods: Circadian variation was analyzed by fitting cosinor models to hourly blood pressure (BP) measurements in patients of the eICU Collaborative Research Database with an ICU length of stay of at least 3 days. We calculated the amplitude of the 24-hour circadian rhythm and time of the day when BP peaked. We determined the association between amplitude and time of peak BP and severity of illness, medications, mechanical intubation, and survival to hospital discharge. Results: Among 23,355 patients (mean age 65 years, 55% male), the mean amplitude of the 24-hour rhythm was 4.5 ± 3.1 mm Hg. Higher APACHE-IV scores, sepsis, organ dysfunction, and mechanical ventilation were associated with a lower amplitude and a shifted circadian rhythm ( P < .05 for all). The timing of the BP peak was associated with in-hospital mortality ( P < .001). Higher BP amplitude was associated with shorter ICU (2 mm Hg amplitude: 7.0 days, 8 mm Hg amplitude: 6.7 days) and hospital (2 mm Hg amplitude: 11.8 days, 8 mm Hg amplitude: 11.3 days) lengths of stay and lower in-hospital mortality (2 mm Hg amplitude: 18.2%, 8 mm Hg amplitude: 15.2%) ( P < .001 for all). Conclusion: The 24-hour rhythm is dampened and phase-shifted in sicker patients and those on mechanical ventilation, vasopressors, or inotropes. Dampening and phase shifting are associated with a longer length of stay and higher in-hospital mortality. (© 2021 Heart Rhythm Society.) |
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| فهرسة مساهمة: | Keywords: Chronobiology; Circadian rhythm; Circadian variation; Cosinor analysis; Critical illness |
| تواريخ الأحداث: | Date Created: 20220310 Latest Revision: 20220311 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC8890071 |
| DOI: | 10.1016/j.cvdhj.2021.01.004 |
| PMID: | 35265899 |
| قاعدة البيانات: | MEDLINE |
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