Key result
In the 24 hours prior to ICU discharge, patients exhibited circadian variations in vital signs that correlated strongly across databases, though the amplitude was reduced by a factor of 2 to 5 compared to healthy adults.
Why the study?
ICU care can disrupt circadian rhythms, which is linked to complications like immune disruption, delirium, and mortality, but ICU practice typically does not emphasize supporting circadian rhythms.
Observational (n=50,298)
Yes
Answers are grounded in this paper and cite their sources.
Patient care in an intensive care unit (ICU) typically involves maintaining homeostasis or ‘normalisation’ of vital signs [ 1 – 3 ], where the body is unable to provide this for itself. However, the process of controlling and regulating vital signs, combined with sedation, inflammation, environmental light, and noise levels, can disrupt a patient’s natural circadian rhythms [ 4 ]. ICU practice in general does not emphasise support of a patient’s circadian rhythms, though there is a growing desire to improve upon this [ 5 ]. Chronically disrupted circadian rhythms are associated with metabolic disorders such as obesity and diabetes, cardiovascular disease, and cancer [ 6 – 9 ]. In an ICU, disruption or loss of a patient’s circadian rhythms is associated with complications such as immune system disruption [ 10 ], delirium [ 11 , 12 ], and mortality [ 13 , 14 ].
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Davidson et al. (2020) conducted an observational in Intensive Care Unit (ICU) recovery prior to discharge (n=50,298). ICU stay prior to discharge vs. Healthy non-ICU cohorts (literature) was evaluated on Presence and correlation of circadian rhythms in vital signs (SBP, HR, RR, T) and peak-nadir excursions (p=≤0.05). In the 24 hours prior to ICU discharge, patients exhibited circadian variations in vital signs that correlated strongly across databases, though the amplitude was reduced by a factor of 2 to 5 compared to healthy adults.
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