Observational studyThe Journal of pediatrics2019
Day-Night Activity in Hospitalized Children after Major Surgery: An Analysis of 2271 Hospital Days.
Observational study in The Journal of pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04989790 (Clinical Effectiveness of the "PICU Up!" Multifaceted Early Mobility Intervention for Critically Ill Children), which is not on this map. Cited by 17 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Clinical Effectiveness of the "PICU Up!" Multifaceted Early Mobility Intervention for Critically Ill Children: A Pragmatic, Stepped-wedge Trial
Who cites it
17 citing papers in PubMed.
- Aberrant DNA methylation within circadian entrainment and clock genes two years after pediatric critical illness is associated with impaired physical and neurocognitive development.Clinical epigenetics · 2025Trial
- Wearable Sleep and Circadian Monitoring in Intensive Care Nursing: A Scoping Review.Nursing in critical care · 2026Article
- Effect of maternal voice on sleep quality in children following cardiac surgery: protocol for a randomized controlled trial.Frontiers in medicine · 2026Article
- Effects of anaesthesia and surgery on sleep-wake timing and subjective sleep quality in children: an observational study.Anaesthesia · 2025Observational
- Nurses' perceptions of the layout and environment of the paediatric intensive care unit in terms of sleep promotion.Nursing in critical care · 2025Article
- Sleep fragmentation in critically ill children: a review of contributing factors in the pediatric intensive care unit and neurodevelopmental outcomes.Frontiers in sleep · 2025Review
- Impact of an Intervention Aimed at Improving Sleep Quality in Hospitalized Children.Children (Basel, Switzerland) · 2024Article
- Sources of Sound Exposure in Pediatric Critical Care.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2024Article
- A nursing perspective on inpatient sleep and circadian disruptions for pediatric stem cell transplant patients.Pediatric blood & cancer · 2024Article
- Sleep disruption and delirium in critically ill children: Study protocol feasibility.Research in nursing & health · 2022Article
- Study protocol for a two-center test of a nurse-implemented chronotherapeutic restoring bundle in critically ill children: RESTORE Resilience (RContemporary clinical trials communications · 2021Article
- Quantifying the Predictive Performance of Objectively Measured Physical Activity on Mortality in the UK Biobank.The journals of gerontology. Series A, Biological sciences and medical sciences · 2021Article
- Assessment and Monitoring of Sleep in the Intensive Care Unit.Critical care nursing clinics of North America · 2021Review
- A pilot study of high frequency accelerometry-based sedation and agitation monitoring in critically ill patients.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2020Article
- Exploration of Disparities in Regions and Specialized Fields of Day Surgery System.International journal of environmental research and public health · 2020Article
- Quantification of Similarity Relationships According to Parameters of Day Surgery System.International journal of environmental research and public health · 2019Article
- Screen time and sleep duration in pediatric critical care: Secondary analysis of a pilot observational study.Journal of pediatric nursingObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
objectivesTo characterize the day-night activity patterns of children after major surgery and describe differences in children's activity patterns between the pediatric intensive care unit (PICU) and inpatient floor setting. STUDY
designIn this prospective observational study, we characterized the daytime activity ratio estimate (DARE; ratio between mean daytime activity [08:00-20:00] and mean 24-hour activity [00:00-24:00]) for children admitted to the hospital after major surgery. The study sample included 221 infants and children ages 1 day to 17 years admitted to the PICU at a tertiary, academic children's hospital. Subjects were monitored with continuous accelerometry from postoperative day 1 until hospital discharge. The National Health and Nutrition Examination Survey accelerometry data were utilized for normative data to compare DARE in a community sample of US children to hospitalized children.
resultsThe mean DARE over 2271 hospital days was 57.8%, with a significant difference between the average DARE during PICU days and inpatient floor days (56% vs 61%, P < .0001). The average subject DARE ranged from 43% to 73%. In a covariate-adjusted mixed effects model, PICU location, lower age, orthopedic or urologic surgery, and intubation time were associated with decreased DARE. Hospitalized children had significantly lower DARE than the National Health and Nutrition Examination Survey subjects in all age groups studied, with the largest difference in the youngest PICU group analyzed (6-9 years; 59% vs 75%, P < .0001). A subset analysis of children older than 2 years (n = 144) showed that DARE was <50% on 15% of hospital days.
conclusionsChildren hospitalized after major surgery experience disruptions in day-night activity patterns during their hospital stay that may reflect disturbances in circadian rhythm.
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