Intensive care unit patients with severe traumatic brain injury, trauma, or medical conditions had significantly lower serum melatonin concentrations compared to healthy controls (p<0.0001).
Observational (n=51)
No
Does ICU admission for TBI, trauma, or medical conditions reduce serum melatonin levels compared to healthy volunteers?
ICU admission, regardless of the underlying condition (TBI, trauma, or medical), is associated with decreased serum melatonin concentrations compared to healthy volunteers.
Absolute Event Rate: 8.9% vs 27%
p-value: p=<0.0001
Melatonin is an endogenous hormone mainly produced by the pineal gland whose dysfunction leads to abnormal sleeping patterns. Changes in melatonin have been reported in acute traumatic brain injury (TBI); however, the impact of environmental conditions typical of the intensive care unit (ICU) has not been assessed. The aim of this study was to compare daily melatonin production in three patient populations treated at the ICU to differentiate the role of TBI versus ICU conditions. Forty-five patients were recruited and divided into severe TBI, trauma without TBI, medical conditions without trauma, and compared to healthy volunteers. Serum melatonin levels were measured at four daily intervals at 0400 h, 1000 h, 1600 h, and 2200 h for 7 days post-ICU admission by commercial enzyme linked immunosorbent assay. The geometric mean concentrations (95% confidence intervals) of melatonin in these groups showed no difference being 8.3 (6.3-11.0), 9.3 (7.0-12.3), and 8.9 (6.6-11.9) pg/mL, respectively, in TBI, trauma, and intensive care cohorts. All of these patient groups demonstrated decreased melatonin concentrations when compared to control patients. This study suggests that TBI as well as ICU conditions, may have a role in the dysfunction of melatonin. Monitoring and possibly substituting melatonin acutely in these settings may assist in ameliorating long-term sleep dysfunction in all of these groups, and possibly contribute to reducing secondary brain injury in severe TBI.
Seifman et al. (Mon,) conducted a observational in Traumatic Brain Injury, Trauma, Intensive Care (n=51). Intensive Care Unit admission (TBI, trauma, or medical conditions) vs. Healthy volunteers was evaluated on Geometric mean serum melatonin concentration (pg/mL) (p=<0.0001). Intensive care unit patients with severe traumatic brain injury, trauma, or medical conditions had significantly lower serum melatonin concentrations compared to healthy controls (p<0.0001).
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