Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK.
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford University Hospitals NHS Trust, NIHR Biomedical Research Centre, Oxford, UK.
Crit Care. 2021 Apr 22;25(1):156. doi: 10.1186/s13054-021-03574-w.
Disrupted vital-sign circadian rhythms in the intensive care unit (ICU) are associated with complications such as immune system disruption, delirium and increased patient mortality. However, the prevalence and extent of this disruption is not well understood. Tools for its detection are currently limited.
This paper evaluated and compared vital-sign circadian rhythms in systolic blood pressure, heart rate, respiratory rate and temperature. Comparisons were made between the cohort of patients who recovered from the ICU and those who did not, across three large, publicly available clinical databases. This comparison included a qualitative assessment of rhythm profiles, as well as quantitative metrics such as peak-nadir excursions and correlation to a demographically matched 'recovered' profile.
Circadian rhythms were present at the cohort level in all vital signs throughout an ICU stay. Peak-nadir excursions and correlation to a 'recovered' profile were typically greater throughout an ICU stay in the cohort of patients who recovered, compared to the cohort of patients who did not.
These results suggest that vital-sign circadian rhythms are typically present at the cohort level throughout an ICU stay and that quantitative assessment of these rhythms may provide information of prognostic use in the ICU.
重症监护病房（ICU）中生命体征昼夜节律的紊乱与免疫系统紊乱、谵妄和患者死亡率增加等并发症有关。然而，这种紊乱的普遍性和程度尚不清楚。目前用于检测它的工具还很有限。
本文评估和比较了 ICU 中收缩压、心率、呼吸率和体温的生命体征昼夜节律。在三个大型公共临床数据库中，比较了从 ICU 中恢复的患者队列和未恢复的患者队列。这种比较包括对节律谱的定性评估，以及对峰值-谷值偏移和与人口统计学匹配的“恢复”谱的相关性等定量指标的评估。
在 ICU 期间，所有生命体征的昼夜节律在队列水平上都存在。与未恢复的患者队列相比，在 ICU 期间，恢复的患者队列中通常存在更大的峰值-谷值偏移和与“恢复”谱的相关性。
这些结果表明，在 ICU 期间，生命体征昼夜节律通常在队列水平上存在，并且对这些节律的定量评估可能为 ICU 中的预后提供有价值的信息。
