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Epidemiology Outcomes
One-Hour Concurrent Session

Critical Care Chronobiology: Should We Reset the Clocks?

Tuesday, February 25, 2025
3:45pm – 4:45pm Eastern Time
Location: W224GH
CE: 1

Emerging evidence shows that ICU patients experience significant disruption in sleep and circadian rhythm, which has been linked to increased delirium, length of stay, and death. Interventional trials are under way in the adult ICU to mitigate this morbidity using environmental adaptions and light exposure. This updated evidence is crucial to increasing the standard of care in the adult ICU. This area of research is lagging in the PICU due to obstacles to measuring pediatric sleep and the possibility that circadian dysregulation in adult ICUs differs from that in PICUs. Experts on melatonin levels and circadian rhythm of critically ill children discuss emerging evidence supporting this distinction. Focus on sleep could have more impact in the PICU than in the adult ICU since children actively grow and neurologically develop as they sleep; this is why they sleep twice as much as adults.

Learning Objectives:

  • Recognize modifiable aspects of the ICU that can increase morbidity by negatively impacting sleep quality and the circadian rhythm
  • Describe differences in circadian rhythm between critically ill children and adults and why this could be important to patient outcomes
  • Identify available methods for measuring sleep architecture and circadian rhythm of critically ill children and the strengths and weaknesses of each
  • Discuss application of changes to daily clinical practice that will improve the sleep of patients in adult and pediatric ICUs

Presentations:

  • 3:50pm – 4:05pm Eastern Time
    Environmental Aspects of the ICU That Cause Sleep and Circadian Dysregulation and the Current Evidence to Improve Them

    Kathleen Nealon, MD (she/her/hers)

  • 4:05pm – 4:20pm Eastern Time
    What Is Known About the Impact of the ICU on MT Levels and the Circadian Rhythms of Critically Ill Adults and Children?

    Lisa D. Burry, PharmD, PhD, FCCM, FCCP (she/her/hers)

  • 4:20pm – 4:35pm Eastern Time
    Elephant in the Room: How to Measure the Sleep of a Critically Ill Child for Multicenter Trials to Be Feasible

    Amanda B. Hassinger, MD, MS, MSc (she/her/hers) – John R Oishei Children's Hospital