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Circadian rhythm disruption in critically ill patients.

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Title: Circadian rhythm disruption in critically ill patients.
Authors: Felten, Matthias (AUTHOR), Dame, Christof (AUTHOR), Lachmann, Gunnar (AUTHOR), Spies, Claudia (AUTHOR), Rubarth, Kerstin (AUTHOR), Balzer, Felix (AUTHOR), Kramer, Achim (AUTHOR), Witzenrath, Martin (AUTHOR)
Source: Acta Physiologica. May2023, Vol. 238 Issue 1, p1-17. 17p. 1 Color Photograph, 4 Graphs.
Subjects: Circadian rhythms, Critically ill patient care, Critically ill, Night work, Septic shock, Intensive care patients, Biological rhythms
Abstract: Patients admitted to the intensive care unit (ICU) are in need of continuous organ replacement strategies and specialized care, for example because of neurological dysfunction, cardio‐pulmonary instability, liver or kidney failure, trauma, hemorrhagic or septic shock or even preterm birth. The 24‐h nursing and care interventions provided to critically ill patients significantly limit resting and/or recovery phases. Consecutively, the patient's endogenous circadian rhythms are misaligned and disrupted, which in turn may interfere with their critical condition. A more thorough understanding of the complex interactions of circadian effectors and tissue‐specific molecular clocks could therefore serve as potential means for enhancing personalized treatment in critically ill patients, conceivably restoring their circadian network and thus accelerating their physical and neurocognitive recovery. This review addresses the overarching issue of how circadian rhythms are affected and disturbed in critically ill newborns and adults in the ICU, and whether the conflicting external or environmental cues in the ICU environment further promote disruption and thus severity of illness. We direct special attention to the influence of cell‐type specific molecular clocks on with severity of organ dysfunctions such as severity of brain dysfunction, pneumonia‐ or ventilator‐associated lung inflammation, cardiovascular instability, liver and kidney failure, trauma, and septic shock. Finally, we address the potential of circadian rhythm stabilization to enhance and accelerate clinical recovery. [ABSTRACT FROM AUTHOR]
Copyright of Acta Physiologica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Circadian rhythm disruption in critically ill patients.
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  Data: <searchLink fieldCode="AR" term="%22Felten%2C+Matthias%22">Felten, Matthias</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dame%2C+Christof%22">Dame, Christof</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lachmann%2C+Gunnar%22">Lachmann, Gunnar</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Spies%2C+Claudia%22">Spies, Claudia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rubarth%2C+Kerstin%22">Rubarth, Kerstin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Balzer%2C+Felix%22">Balzer, Felix</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kramer%2C+Achim%22">Kramer, Achim</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Witzenrath%2C+Martin%22">Witzenrath, Martin</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Physiologica%22">Acta Physiologica</searchLink>. May2023, Vol. 238 Issue 1, p1-17. 17p. 1 Color Photograph, 4 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Circadian+rhythms%22">Circadian rhythms</searchLink><br /><searchLink fieldCode="DE" term="%22Critically+ill+patient+care%22">Critically ill patient care</searchLink><br /><searchLink fieldCode="DE" term="%22Critically+ill%22">Critically ill</searchLink><br /><searchLink fieldCode="DE" term="%22Night+work%22">Night work</searchLink><br /><searchLink fieldCode="DE" term="%22Septic+shock%22">Septic shock</searchLink><br /><searchLink fieldCode="DE" term="%22Intensive+care+patients%22">Intensive care patients</searchLink><br /><searchLink fieldCode="DE" term="%22Biological+rhythms%22">Biological rhythms</searchLink>
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  Data: Patients admitted to the intensive care unit (ICU) are in need of continuous organ replacement strategies and specialized care, for example because of neurological dysfunction, cardio‐pulmonary instability, liver or kidney failure, trauma, hemorrhagic or septic shock or even preterm birth. The 24‐h nursing and care interventions provided to critically ill patients significantly limit resting and/or recovery phases. Consecutively, the patient's endogenous circadian rhythms are misaligned and disrupted, which in turn may interfere with their critical condition. A more thorough understanding of the complex interactions of circadian effectors and tissue‐specific molecular clocks could therefore serve as potential means for enhancing personalized treatment in critically ill patients, conceivably restoring their circadian network and thus accelerating their physical and neurocognitive recovery. This review addresses the overarching issue of how circadian rhythms are affected and disturbed in critically ill newborns and adults in the ICU, and whether the conflicting external or environmental cues in the ICU environment further promote disruption and thus severity of illness. We direct special attention to the influence of cell‐type specific molecular clocks on with severity of organ dysfunctions such as severity of brain dysfunction, pneumonia‐ or ventilator‐associated lung inflammation, cardiovascular instability, liver and kidney failure, trauma, and septic shock. Finally, we address the potential of circadian rhythm stabilization to enhance and accelerate clinical recovery. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Acta Physiologica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/apha.13962
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      – Code: eng
        Text: English
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        PageCount: 17
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      – SubjectFull: Circadian rhythms
        Type: general
      – SubjectFull: Critically ill patient care
        Type: general
      – SubjectFull: Critically ill
        Type: general
      – SubjectFull: Night work
        Type: general
      – SubjectFull: Septic shock
        Type: general
      – SubjectFull: Intensive care patients
        Type: general
      – SubjectFull: Biological rhythms
        Type: general
    Titles:
      – TitleFull: Circadian rhythm disruption in critically ill patients.
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            – D: 01
              M: 05
              Text: May2023
              Type: published
              Y: 2023
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