Metabolomics pilot study identifies circadian desynchronization and distinct intra-patient variability patterns in critical illness

MedRxiv : the Preprint Server for Health Sciences
Elizabeth R LusczekG. Cornelissen-Guillaume

Abstract

Background: Synchronized circadian rhythms play a key role in coordinating physiologic health. Desynchronized circadian rhythms may predispose individuals to disease or be indicative of underlying disease. Intensive care unit (ICU) patients likely experience desynchronized circadian rhythms due to disruptive environmental conditions in the ICU and underlying pathophysiology. This observational pilot study was undertaken to determine if circadian rhythms are altered in ICU patients relative to healthy controls by profiling circadian rhythms in vital signs and plasma metabolites. Methods: We monitored circadian rhythms in 5 healthy controls and 5 ICU patients for 24 hours. Heart rate and blood pressure were measured every 30 minutes, temperature was measured every hour, and blood was sampled for mass spectrometry-based plasma metabolomics every 4 hours. Bedside sound levels were measured every minute. Circadian rhythms were evaluated in vitals and plasma metabolites individually and in each group using the cosinor method. Results: ICU patient rooms were significantly louder than healthy controls' rooms and average noise levels were above EPA recommendations. Healthy controls generally had significant circadian rhythms individuall...Continue Reading

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