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Abstract

s Aim: To examine whether the serum melatonin levels in ICU patients are affected by light exposure in the "light" and "dark" parts of the ICU. Method: We measured serum melatonin levels of 10 ICU patients having their bed positioned in the "light part" (artificial and natural light) and "dark part" (only artificial light) of the ICU at two different time points, 8:00 ("morning") and 20:00 ("evening") during a 24-96-h period. Results: Serum melatonin levels did not differ between "morning" (112 ± 15 pg/ml) and "evening" (87 ± 13 pg/ml) in ICU patients. Overall, higher melatonin levels were detected in female patients compared to male patients. Significantly higher light intensity was detected in the "light part" compared to the "dark part" of the ICU, not only in the "morning" but also in the "evening". However, by dividing patients according to their bed positioning ("light part" versus "dark part") in the ICU, no difference was detected in the serum melatonin levels. Similarly, the ratio ("morning" versus "evening") of light intensity and melatonin levels did not differ between the light and dark parts of the ICU. Conclusion: Studies reporting melatonin patterns in ICU patients are heterogeneous and contradictory, which renders this topic highly challenging. Larger studies regarding the effect of light exposure on melatonin levels in ICU patients are required to reveal the true impact and indicate potential nursing interventions.
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Effect of Light Exposure on Serum Melatonin Levels of
ICU Patients: A Preliminary Observational Study
Α Korompeli1*, L Molcan2*, N Kavrochorianou1*, T Katsoulas1, P Myrianthefs1 and G Fildissis1
1National and Kapodistrian University of Athens, University ICU, Ag. Anargyroi General Hospital, Athens, Greece
2Department of Animal Physiology and Ethology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
Research Article Copyright © All rights are reserved by Α Korompeli
ISSN: 2641-1911 DOI: 10.33552/ANN.2022.12.000792
Archives in
Neurology & Neuroscience
This work is licensed under Creative Commons Attribution 4.0 License
ANN.MS.ID.000792.
*Corresponding author: Dr Anna Korompeli, National and Kapodistrian Univer-
sity of Athens, University ICU, Ag. Anargyroi General Hospital, Noufaron & Timiou

Received Date: May 02, 2022
Published Date: May 16, 2022
Abstracts
Aim:
Method:

Results:        
  
    


Conclusion:                
             

Keywords: 
Introduction


    




    

      
  
 

  
         
        
     
      
       
     
Archives in Neurology and Neuroscience Volume 12-Issue 4
Citation: 

10.33552/ANN.2022.11.000792
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  

   





Intense night lights, something prevalent in the ICU
   





     
in ICU patients.
Materials and Methods
Ethical and research approvals
        

       
       
        
 

ICU design
       
       
at a Greek general hospital in Athens. Total admissions at this ICU


ICU, resulting in a longer mean length of stay. The windows offered
  
       
 
           



          

       

 

          

  

         


Eligibility criteria
  
      


    o  

       
 
          
        

  
      
         
       
       
          
irregularities. Measurement of melatonin levels.
  
          
          
    
          
      
       
        
    
          

Light levels
       
       
       
   

Data analysis and statistical evaluation
      
         
Shapiro-Wilk test of normality was applied, and when proven
          

       



   
           


Citation: 

10.33552/ANN.2022.11.000792
Archives in Neurology and Neuroscience Volume 12-Issue 4
Page 3 of 7
Table 1: Characteristics of ICU patients.
All patients
(mean ± SEM)
[min – max]
Male
(mean ± SEM)
[min – max]
Female
(mean ± SEM)
[min – max]
p-value (male vs female)
n 10
n, light part 3 1
n, dark part 3 3
 70.1    
  23.0  9.0  
   25.0  
 9.5  9.2  10.0  
Table 2: Comparison of the light intensity between the dark and light part of the ICU.
Light part, lux
(mean ± SEM)
[min – max]
Dark part, lux
(mean ± SEM)
[min – max]
p-value
 220   
 55   
Figure 1: Graphical display of a correlation coe󰀩cient matrix of selected parameters separately in the “morning” and “evening”. The correlation
matrix contains the correlation coe󰀩cients. The coloured correlation coe󰀩cients represent a signicant (p < 0.05) correlation. Male = 1, Female
= 2, Light ICU part = 1, Dark ICU part = 0.
Results
 

             
 
  

     
       
       


           

        
        
          

Then, we measured serum melatonin levels in all ICU patients



Archives in Neurology and Neuroscience Volume 12-Issue 4
Citation: 

10.33552/ANN.2022.11.000792
Page 4 of 7
Figure 2: Comparison of serum melatonin measured in the “morning” (8:00; n=10) and in the “evening” (20:00; n=10).

light exposure in the light and dark ICU part, we analysed melatonin
 
  

      
          
       
          
       



Figure 3: E󰀨ects of ICU part (A) and gender (B) and on serum melatonin levels measured in the “morning” (8:00; n=10) and in the “evening”
(20:00; n=10).
Citation: 

10.33552/ANN.2022.11.000792
Archives in Neurology and Neuroscience Volume 12-Issue 4
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

ICU, although the light intensity was lower than in the light part of



Figure 4: Ratio (“morning” / “evening”) of serum melatonin levels (A) and light intensity (B) expressed for ICU patients separately in the light
and dark part of the ICU.
Discussion
       
       
melatonin levels. ICU patients were exposed to environmental
       
       
 


   
       
          
       
           
        
        
          
         
period, in ICU patients.
Towards this purpose, we measured the serum melatonin levels
          

     

        
serum melatonin levels were slightly higher in the ICU patients
relative to those reported in the literature for healthy individuals
    

    

       
         
         
           
    
  
         
    


      
 

     


        
          
         
      
          
Archives in Neurology and Neuroscience Volume 12-Issue 4
Citation: 

10.33552/ANN.2022.11.000792
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     
       
       
  
       

    
           
  
         
     
A previous study showed that plasma melatonin levels were not

          
          
     
    
         
       
        
 
    

 
         


[10].
Conclusion
       
         
  


       

  
   
part of the ICU or to the study of melatonin levels at only two time-



       
the synthesis and release of melatonin were not impeded at the

        
      
       





Limitations
     
   
         
  

   

    
       
      

However, melatonin is a hormone predominantly present in plasma

and measure melatonin ideally in the middle of the night. To
      


Relevance to Clinical Practice
         
        

           
          
 

         



the ICU.
Disclosure of interest

References
1.           



2.          
       
371-379.
3. 

4.         

5.           
   

6.         

7.         

8.            
     
sedation or non-sedation. Annals of Intensive Care 11.
Citation: 

10.33552/ANN.2022.11.000792
Archives in Neurology and Neuroscience Volume 12-Issue 4
Page 7 of 7
9. 
al.         
         
320-325.
10. 
         

11.             

      

12.  

13.          
        

14.     
           

15.      


16.           
       
Computing.
17.         
     
tidyverse.org
18. 


19.          
        


20.          

21.           

        
  

22.        
          


23.     

24. 


25.           
       
   

26.            

       

27.            

28.           
     

29. 
     

30. 
      
      

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Importance Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. Observations Each year, more than 19 million individuals develop sepsis, defined as a life-threatening acute organ dysfunction secondary to infection. Approximately 14 million survive to hospital discharge and their prognosis varies. Half of patients recover, one-third die during the following year, and one-sixth have severe persistent impairments. Impairments include development of an average of 1 to 2 new functional limitations (eg, inability to bathe or dress independently), a 3-fold increase in prevalence of moderate to severe cognitive impairment (from 6.1% before hospitalization to 16.7% after hospitalization), and a high prevalence of mental health problems, including anxiety (32% of patients who survive), depression (29%), or posttraumatic stress disorder (44%). About 40% of patients are rehospitalized within 90 days of discharge, often for conditions that are potentially treatable in the outpatient setting, such as infection (11.9%) and exacerbation of heart failure (5.5%). Compared with patients hospitalized for other diagnoses, those who survive sepsis (11.9%) are at increased risk of recurrent infection than matched patients (8.0%) matched patients (P < .001), acute renal failure (3.3% vs 1.2%, P < .001), and new cardiovascular events (adjusted hazard ratio [HR] range, 1.1-1.4). Reasons for deterioration of health after sepsis are multifactorial and include accelerated progression of preexisting chronic conditions, residual organ damage, and impaired immune function. Characteristics associated with complications after hospital discharge for sepsis treatment are not fully understood but include both poorer presepsis health status, characteristics of the acute septic episode (eg, severity of infection, host response to infection), and quality of hospital treatment (eg, timeliness of initial sepsis care, avoidance of treatment-related harms). Although there is a paucity of clinical trial evidence to support specific postdischarge rehabilitation treatment, experts recommend referral to physical therapy to improve exercise capacity, strength, and independent completion of activities of daily living. This recommendation is supported by an observational study involving 30 000 sepsis survivors that found that referral to rehabilitation within 90 days was associated with lower risk of 10-year mortality compared with propensity-matched controls (adjusted HR, 0.94; 95% CI, 0.92-0.97, P < .001). Conclusions and Relevance In the months after hospital discharge for sepsis, management should focus on (1) identifying new physical, mental, and cognitive problems and referring for appropriate treatment, (2) reviewing and adjusting long-term medications, and (3) evaluating for treatable conditions that commonly result in hospitalization, such as infection, heart failure, renal failure, and aspiration. For patients with poor or declining health prior to sepsis who experience further deterioration after sepsis, it may be appropriate to focus on palliation of symptoms.