Melatonin: possible implications for the postoperative and critically ill patient

被引:87
作者
Bourne, RS
Mills, GH
机构
[1] Royal Hallamshire Hosp, Intens Care Unit, Sheffield S10 2JF, S Yorkshire, England
[2] Royal Hallamshire Hosp, Med Econ & Res Ctr, Sheffield S10 2JF, S Yorkshire, England
关键词
circadian rhythm; critical illness; delirium; melatonin; sepsis; sleep disorders;
D O I
10.1007/s00134-005-0061-x
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
There is increasing interest in the hormone melatonin in postoperative and critically ill patients. The roles of melatonin in the regulation of the sleep-wake cycle, resetting of circadian rhythm disturbances and its extensive antioxidant activity have potential applications in these patient groups. The interaction between melatonin and the stresses of surgery and critical illness are explored in the context of circadian rhythms, sleep disorders and delirium. The antioxidant activity is discussed in terms of the reduction of ischaemic reperfusion injury, prevention of multi-organ failure and treatment of sepsis. Unfortunately, there is currently insufficient evidence that exogenous melatonin is effective in preventing or treating postoperative delirium. Similarly, in the critically ill patient, sleep disorders are associated with disrupted melatonin circadian secretion, but there is a paucity of data to support routine exogenous melatonin supplementation. More clinical evidence to confirm the potential benefits of melatonin therapy is required before it can be routinely used in the postoperative or critically ill patient.
引用
收藏
页码:371 / 379
页数:9
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