G A Nuttall1, M Kumar, M J Murray. 1. Department of Anesthesiology and Critical Care Service, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Abstract
OBJECTIVE: To determine if a difference exists in the circadian rhythm entrainment between patients with and without intensive care unit (ICU) psychosis. DESIGN: Retrospective chart reviews from 149 consecutive patients admitted to our ICU during the period of January 1993 to August 1993. Twelve patients with a history of mental illness or alcohol or substance abuse were excluded from the study. SETTING: A 20-bed surgical ICU at a large teaching hospital. PATIENTS: Patients who remained in the ICU for a minimum of 2 days after undergoing thoracic or vascular operations. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Hourly temperature and urine output were ascertained from the patient records. The time of temperature and urine output nadir was used as a marker of circadian rhythm. Of the 137 patients included in the study, 17 (12.4%) developed ICU psychosis as defined by standard criteria. The time of temperature nadir was randomly distributed around the clock for each group. Cosinar rhythmometry analysis of temperature data showed a lack of circadian rhythm entrainment in most patients up to the third postoperative day. No statistically significant difference exists in the deviation of such impairment between the groups. CONCLUSION: Either patients who develop ICU psychosis have an increased sensitivity to an alteration of their circadian rhythm, or ICU psychosis develops independent of circadian rhythm abnormalities.
OBJECTIVE: To determine if a difference exists in the circadian rhythm entrainment between patients with and without intensive care unit (ICU) psychosis. DESIGN: Retrospective chart reviews from 149 consecutive patients admitted to our ICU during the period of January 1993 to August 1993. Twelve patients with a history of mental illness or alcohol or substance abuse were excluded from the study. SETTING: A 20-bed surgical ICU at a large teaching hospital. PATIENTS: Patients who remained in the ICU for a minimum of 2 days after undergoing thoracic or vascular operations. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Hourly temperature and urine output were ascertained from the patient records. The time of temperature and urine output nadir was used as a marker of circadian rhythm. Of the 137 patients included in the study, 17 (12.4%) developed ICU psychosis as defined by standard criteria. The time of temperature nadir was randomly distributed around the clock for each group. Cosinar rhythmometry analysis of temperature data showed a lack of circadian rhythm entrainment in most patients up to the third postoperative day. No statistically significant difference exists in the deviation of such impairment between the groups. CONCLUSION: Either patients who develop ICU psychosis have an increased sensitivity to an alteration of their circadian rhythm, or ICU psychosis develops independent of circadian rhythm abnormalities.
Authors: Vasilios E Papaioannou; Eleni N Sertaridou; Ioanna G Chouvarda; George C Kolios; Ioannis N Pneumatikos Journal: Intensive Care Med Exp Date: 2019-09-05
Authors: Xiaopeng Zhang; Xiaowei Yan; Jennifer Gorman; Stuart N Hoffman; Li Zhang; Joseph A Boscarino Journal: Neuropsychiatr Dis Treat Date: 2014-02-19 Impact factor: 2.570