Circadian rhythms: from basic mechanisms to the intensive care unit

Crit Care Med. 2012 Jan;40(1):246-53. doi: 10.1097/CCM.0b013e31822f0abe.

Abstract

Objective: : Circadian rhythms are intrinsic timekeeping mechanisms that allow for adaptation to cyclic environmental changes. Increasing evidence suggests that circadian rhythms may influence progression of a variety of diseases as well as effectiveness and toxicity of drugs commonly used in the intensive care unit. In this perspective, we provide a brief review of the molecular mechanisms of circadian rhythms and its relevance to critical care. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION, AND DATA SYNTHESIS:: Articles related to circadian rhythms and organ systems in normal and disease conditions were searched through the PubMed library with the goal of providing a concise review.

Conclusions: : Critically ill patients may be highly vulnerable to disruption of circadian rhythms as a result of the severity of their underlying diseases as well as the intensive care unit environment where noise and frequent therapeutic/diagnostic interventions take place. Further basic and clinical research addressing the importance of circadian rhythms in the context of critical care is warranted to develop a better understanding of the complex pathophysiology of critically ill patients as well as to identify novel therapeutic approaches for these patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Coagulation / physiology
  • Cardiovascular Physiological Phenomena
  • Circadian Rhythm / physiology*
  • Critical Care / methods
  • Critical Illness
  • Humans
  • Immunity / physiology
  • Intensive Care Units*
  • Kidney / metabolism
  • Kidney / physiology
  • Liver / metabolism
  • Liver / physiology
  • Respiratory Physiological Phenomena