title: Circadian rhythms in anesthesia and critical care medicine: potential importance of circadian disruptions.
abstract: The rotation of the earth and associated alternating cycles of light and dark--the basis of our circadian rhythms--are fundamental to human biology and culture. However, it was not until 1971 that researchers first began to describe the molecular mechanisms for the circadian system. During the past few years, groundbreaking research has revealed a multitude of circadian genes affecting a variety of clinical diseases, including diabetes, obesity, sepsis, cardiac ischemia, and sudden cardiac death. Anesthesiologists, in the operating room and intensive care units, manage these diseases on a daily basis as they significantly affect patient outcomes. Intriguingly, sedatives, anesthetics, and the intensive care unit environment have all been shown to disrupt the circadian system in patients. In the current review, we will discuss how newly acquired knowledge of circadian rhythms could lead to changes in clinical practice and new therapeutic concepts.
authors.affiliation: University of Colorado Denver, Aurora, CO, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Brainard
authors.affiliation: University of Colorado Denver, Aurora, CO, USA.
authors.forename: Merit
authors.initials: M
authors.lastname: Gobel
authors.affiliation: University of Colorado Denver, Aurora, CO, USA.
authors.forename: Karsten
authors.initials: K
authors.lastname: Bartels
authors.affiliation: University of Colorado Denver, Aurora, CO, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Scott
authors.affiliation: University of Colorado Denver, Aurora, CO, USA Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Koeppen
authors.affiliation: University of Colorado Denver, Aurora, CO, USA tobias.eckle@ucdenver.edu.
authors.forename: Tobias
authors.initials: T
authors.lastname: Eckle
mesh_terms: D000758:Anesthesia / Q000379:methods*; D000776:Anesthesiology; D002940:Circadian Rhythm / Q000502:physiology*; D003422:Critical Care / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units
keywords: Per2; anesthesia; circadian rhythm; cognitive dysfunction; critical care medicine; diabetes mellitus; genetic determinants; glucose oxidation; hypertension; inflammation