title: A 24-h work shift in intensive care personnel: biological pathways between work stress and ill health.
abstract: This study evaluated inflammatory, coagulation and microvascular responses to a continuous 24-h work day in 13 healthy intensive care physicians. Inflammatory markers (interleukin [IL]-2, IL-6, IL-10, tumour necrosis factor-α, matrix metalloproteinase [MMP]-9 and adiponectin), adhesion molecules (vascular cellular adhesion molecule-1 and intercellular adhesion molecule-1 [ICAM-1]), coagulation parameters (thrombin-anti thrombin, von Willebrand factor and tissue factor) and sublingual micro circulation were assessed before and after a 24-h work shift. The 24-h work shift had no effect on inflammatory markers and ICAM-1. Direct visualization of micro-circulation did not reveal stress-related perfusion abnormalities. A 24-h work shift in the intensive care unit was associated with significantly increased plasma levels of tissue factor - a potentially important mechanism linking acute job strain, haemostasis and atherosclerosis. The long-term consequences warrant further evaluation.
authors.affiliation: First Medical Department, Intensive Care Unit, Charles University in Prague, Faculty of Medicine in Plzen, University Hospital Plzen, Czech Republic. matejovic@fnplzen.cz
authors.forename: M
authors.initials: M
authors.lastname: Matejovic
authors.forename: J
authors.initials: J
authors.lastname: Chvojka
authors.forename: R
authors.initials: R
authors.lastname: Sykora
authors.forename: A
authors.initials: A
authors.lastname: Krouzecky
authors.forename: J
authors.initials: J
authors.lastname: Radej
authors.forename: R
authors.initials: R
authors.lastname: Parizkova
authors.forename: P
authors.initials: P
authors.lastname: Dostal
authors.forename: I
authors.initials: I
authors.lastname: Novak
authors.forename: V
authors.initials: V
authors.lastname: Cerny
mesh_terms: D000328:Adult; D001686:Biological Phenomena; D015415:Biomarkers / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006262:Health; D006282:Health Personnel; D006439:Hemodynamics; D006487:Hemostasis; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D007362:Intensive Care Units; D008297:Male; D008833:Microcirculation; D013312:Stress, Physiological; D013925:Thromboplastin / Q000378:metabolism; D013997:Time Factors
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D013925:Thromboplastin