Abnormal environmental light exposure in the intensive care environment

作者：Fan Emily P; Abbott Sabra M; Reid Kathryn J; Zee Phyllis C; Maas Matthew B^*

来源：Journal of Critical Care, 2017, 40: 11-14.

DOI：10.1016/j.jcrc.2017.03.002

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.

• 出版日期2017-8
• 单位西北大学