Abnormal environmental light exposure in the intensive care environment
Abnormal environmental light exposure in the intensive care environment
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DOI：
10.1016/j.jcrc.2017.03.002
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发表时间：
2017-08-01
影响因子：
3.7
通讯作者：
Maas, Matthew B.
中科院分区：
文献类型：
--
作者：
Fan, Emily P.;Abbott, Sabra M.;Maas, Matthew B.
目的：我们试图表征重症监护病房（ICU）环境中的环境光暴露，以确定与昼夜节律调节相关的光暴露模式。方法：在现代重症监护病房，将一个光监测器贴在受试者的床上，并连续记录每位受试者至少24小时的照度。每小时取一次血样，测定血浆褪黑素。每小时对受试者进行生命体征和床边神经学评估。本研究未修改护理方案和ICU环境。结果：共收集到17例受试者的30秒光照数据67,324次。光照强度在上午晚些时候达到峰值，中位数为64.1勒克斯（四分位数范围19.7-138.7）。第75百分位光强仅在上午9点至中午超过100 lx，从未超过150 lx。褪黑素振幅与白天、夜间或总光照没有相关性（Spearman相关系数均< 0.2,p < 0.5）。结论：重症监护病房患者的环境光暴露始终较低，且具有昼夜规律。夜间光照未观察到对褪黑激素分泌的影响。ICU日间光照不足可能导致昼夜节律异常。(C) 2017爱思唯尔公司版权所有。
Purpose: We sought to characterize ambient light exposure in the intensive care unit (ICU) environment to identify patterns of light exposure relevant to circadian regulation.Methods: A light monitor was affixed to subjects' bed at eye level in a modern intensive care unit and continuously recorded illuminescence for at least 24 h per subject. Blood was sampled hourly and measured for plasma melatonin. Subjects underwent hourly vital sign and bedside neurologic assessments. Care protocols and the ICU environment were not modified for the study.Results: A total of 67,324 30-second epochs of light data were collected from 17 subjects. Light intensity peaked in the late morning, median 64.1 (interquartile range 19.7-138.7) lux. The 75th percentile of light intensity exceeded 100 lx only between 9 AM and noon, and never exceeded 150 lx. There was no correlation between melatonin amplitude and daytime, nighttime or total light exposure (Spearman's correlation coefficients all < 0.2 and p > 0.5).Conclusions: Patients' environmental light exposure in the intensive care unit is consistently low and follows a diurnal pattern. No effect of nighttime light exposure was observed on melatonin secretion. Inadequate daytime light exposure in the ICU may contribute to abnormal circadian rhythms. (C) 2017 Elsevier Inc. All rights reserved.