Neonatal Intensive Care Unit, Department of Pediatrics, University of Messina, Messina, Italy.
J Pediatr. 2013 Feb;162(2):357-60. doi: 10.1016/j.jpeds.2012.07.019. Epub 2012 Aug 19.
To evaluate the serum melatonin levels in critically ill pediatric patients and to test the effect of light on the melatonin's circadian rhythm. Data on melatonin secretion in critically ill pediatric subjects are lacking.
We investigated the serum melatonin levels of 16 sedated and mechanically ventilated patients in a pediatric intensive care unit. Children (mean age, 5.1 ± 3.1 years) were randomly assigned to a dark-exposed or to a light-exposed group to evaluate the effects of light on serum melatonin concentrations. Blood samples for serum melatonin analysis were collected at 10 p.m., 1 a.m., 3 a.m., 5 a.m., 8 a.m., and 12 p.m.
The melatonin circadian rhythm was severely disrupted in critically ill children; light exposure lowered serum melatonin even in a context of highly altered circadian cycle; melatonin peaks were greater for healthy age-matched children.
The high melatonin levels in the critically ill children may be a response to counteract the elevated oxidative stress associated with serious diseases. Whether these elevated melatonin levels confer any beneficial effects in pediatric critically ill patients remains unknown.
评估危重症儿科患者的血清褪黑素水平，并检验光对褪黑素昼夜节律的影响。危重症儿科患者的褪黑素分泌数据尚缺乏。
我们调查了儿科重症监护病房 16 名镇静和机械通气患者的血清褪黑素水平。儿童（平均年龄，5.1±3.1 岁）被随机分配到暴露于暗光或暴露于亮光组，以评估光对血清褪黑素浓度的影响。在晚上 10 点、凌晨 1 点、3 点、5 点、早上 8 点和中午 12 点采集血样以进行血清褪黑素分析。
危重症儿童的褪黑素昼夜节律严重紊乱；即使在昼夜节律高度改变的情况下，光照仍会降低血清褪黑素；健康同龄儿童的褪黑素峰值更高。
危重症儿童的高褪黑素水平可能是对抗与严重疾病相关的氧化应激增加的反应。这些升高的褪黑素水平是否对儿科危重症患者有任何有益影响尚不清楚。
