ArticleBMC anesthesiology2023
Circadian rhythm disturbance and delirium in ICU patients: a prospective cohort study.
Article in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05342987 (The Relationship Between Delirium and Circadian Rhythm in Intensive Care Unit), which is not on this map. Cited by 12 papers.
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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.
The Relationship Between Delirium and Circadian Rhythm in Intensive Care Unit
Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- Protocol for a feasibility randomised controlled trial of administering daytime only enteral feeding compared to standard continuous enteral feeding, to reduce delirium in mechanically ventilated, critically ill adults, with qualitative and circadian mechanistic sub-studies.Journal of the Intensive Care Society · 2026Article
- Potentials and challenges of an integrative medicine protocol in intensive care: the perspective of intensive care nurses.BMC complementary medicine and therapies · 2026Article
- Circadian disruption of brain temperature and heart rate in two periods after intracerebral hemorrhage surgery: a retrospective study.Scientific reports · 2026Article
- Correspondence: circadian melatonin rhythms in critically ill patients with delirium.Critical care (London, England) · 2026Article
- Association Between Lactate/Albumin Ratio and Delirium Risk in Critically Ill Patients With Acute Heart Failure: A Retrospective Cohort Study.Clinical cardiology · 2026Observational
- A Perioperative Care Strategy for Prevention of Postoperative Delirium in Elderly Patients with Gastrointestinal Tumors: A Clinical Observational Study.Journal of multidisciplinary healthcare · 2026Article
- Effect of external cues on clock-driven protection from influenza A infection.The Journal of clinical investigation · 2025Article
- Sleep Quality, Circadian Rhythm Stability and Changes in Delirium State in Predicting Mortality Risk in Intensive Care Unit Patients: A Prospective Observational Study.Nursing in critical care · 2025Observational
- Circadian clock activity in human umbilical vein endothelial cells of preterm and term neonates.Pediatric research · 2025Article
- Article
- Is delirium after stroke associated with dysregulation of hypothalamic pituitary axis?Frontiers in stroke · 2025Article
- Potential Neuroprotective Role of Melatonin in Sepsis-Associated Encephalopathy Due to Its Scavenging and Anti-Oxidative Properties.Antioxidants (Basel, Switzerland) · 2023Review
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients treated in the intensive care unit (ICU) may experience a reversal of day and night. The circadian rhythm in ICU patients can be disturbed.
methodsTo explore the relationship between ICU delirium and the circadian rhythms of melatonin, cortisol and sleep. A prospective cohort study was carried out in a surgical ICU of a tertiary teaching hospital. Patients who were conscious during the ICU stay after surgery and were scheduled to stay in the ICU for more than 24 h were enrolled. Serum melatonin and plasma cortisol levels were measured three times a day by drawing arterial blood on the first three days after ICU admission. Daily sleep quality was assessed by the Richard-Campbell Sleep Questionnaire (RCSQ). The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was performed twice a day to screen for ICU delirium.
resultsA total of 76 patients were included in this study, and 17 patients developed delirium during their ICU stay. Melatonin levels were different at 8:00 (p = 0.048) on day 1, at 3:00 (p = 0.002) and at 8:00 (p = 0.009) on day 2, and at all three time points on day 3 (p = 0.032, 0.014, 0.047) between delirium and non-delirium patients. The plasma cortisol level in the delirium patients was significantly lower than that in the non-delirium patients at 16:00 on day 1 (p = 0.025). The changes in melatonin and cortisol secretion levels exhibited obvious biological rhythmicity in non-delirium patients (p < 0.001 for melatonin, p = 0.026 for cortisol), while no rhythmicity was found in melatonin and cortisol secretion levels in the delirium group (p = 0.064 for melatonin, p = 0.454 for cortisol). There was no significant difference in RCSQ scores in the first three days between the two groups.
conclusionsThe disturbance of the circadian rhythm of melatonin and cortisol secretion was associated with the development of delirium in ICU patients. Clinical staff should pay more attention to the importance of maintaining patients' normal circadian rhythms in the ICU.
trial registrationThe study was registered with the US National Institutes of Health ClinicalTrials.gov(NCT05342987) (25/04/2022).
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