Evidence map›Paper›PMID 39715945›Full record

ArticleIntensive care medicine experimental2024

Modification in ICU design may influence circadian serum cholinesterase activities: a proof-of-concept pilot study.

Sebastian Schmidt, Maria Heinrich, Klaus-Dieter Wernecke, Claudia Spies, Laura Hancke, Anika Mueller, Alawi Luetz

Registry-linked trialAbstract read
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In one paragraph

Article in Intensive care medicine experimental, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02143661 (eValuatIon of The ALl New Environment for crITicallY Ill Patients), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02143661 completednot on this map

eValuatIon of The ALl New Environment for crITicallY Ill Patients (VITALITY)

TypeobservationalSponsorClaudia SpiesRan2014 to 2019Enrolled74ConditionsIntensive Care Unit Environment
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sebastian Schmidt *Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Maria Heinrich *Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Klaus-Dieter WerneckeInstitute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Claudia SpiesDepartment of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Laura HanckeDepartment of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Anika MuellerDepartment of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Alawi LuetzDepartment of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin and Berlin Institute of Health, Berlin, Germany. alawi.luetz@charite.de.ORCID http://orcid.org/0000-0001-8814-1809

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDeficits in cholinergic function are assumed to cause cognitive decline. Studies have demonstrated that changes in serum cholinesterase activities are associated with a higher incidence of delirium in critically ill patients. Additionally, basic research indicates that the cholinergic and circadian systems are interconnected, with each system influencing the functionality of the other. This data analysis of a proof-of-concept pilot study investigates whether modification in ICU design, including dynamic light therapy, may influence the circadian oscillation of serum cholinesterase activities.

methodsWe enrolled adult critically ill patients who were on mechanical ventilation and had an anticipated ICU stay of at least 48 h. The patients were treated in either modified or standard ICU rooms. The modified rooms received extensive architectural modifications, including a new dynamic lighting system. Serum acetylcholinesterase and butyrylcholinesterase activities were measured every four hours for up to three 24-h assessment periods.

resultsWe included 64 patients in the data analysis (n = 34 patients in modified rooms, n = 30 in standard rooms). The median values of serum acetylcholinesterase and butyrylcholinesterase activities showed different patterns. Acetylcholinesterase activities differed significantly between the groups during the first assessment period (p = 0.04) and the second assessment period (p = 0.045). The intensity of light, as quantified by the effective circadian irradiance, significantly influenced the activities of acetylcholinesterase and butyrylcholinesterase throughout all assessment periods for patients in both groups (p < 0.001). The analysis showed significant interaction (p < 0.001), indicating that the differences in acetylcholinesterase and butyrylcholinesterase activities between the groups were inconsistent over time but apparent during specific periods of the day.

conclusionImplementing a comprehensive set of changes to the design of ICU rooms, including a dynamic lighting system, may influence the course of the activity patterns of acetylcholinesterase and butyrylcholinesterase in critically ill patients. Modifications to environmental factors could potentially offer neuroprotective benefits and facilitate the realignment of circadian rhythms within the cholinergic system. Clinical trial registration ClinicalTrials.gov: NCT02143661. Registered May 21, 2014.

Indexed as

ArchitectureCholinesteraseCircadian rhythmCritical careDeliriumNonpharmacological

Identifiers

PMID39715945
PMCPMC11666856

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.