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dc.contributor.authorMcKenna, Helen
dc.contributor.authorvan der Horst, GTJ
dc.contributor.authorReiss, I
dc.contributor.authorMartin, Daniel
dc.date.accessioned2020-07-09T13:15:28Z
dc.date.issued2018-12
dc.identifier.issn1364-8535
dc.identifier.issn1364-8535
dc.identifier.other124
dc.identifier.urihttp://hdl.handle.net/10026.1/15932
dc.description.abstract

A fundamental aspect of human physiology is its cyclical nature over a 24-h period, a feature conserved across most life on Earth. Organisms compartmentalise processes with respect to time in order to promote survival, in a manner that mirrors the rotation of the planet and accompanying diurnal cycles of light and darkness. The influence of circadian rhythms can no longer be overlooked in clinical settings; this review provides intensivists with an up-to-date understanding of the burgeoning field of chronobiology, and suggests ways to incorporate these concepts into daily practice to improve patient outcomes. We outline the function of molecular clocks in remote tissues, which adjust cellular and global physiological function according to the time of day, and the potential clinical advantages to keeping in time with them. We highlight the consequences of "chronopathology", when this harmony is lost, and the risk factors for this condition in critically ill patients. We introduce the concept of "chronofitness" as a new target in the treatment of critical illness: preserving the internal synchronisation of clocks in different tissues, as well as external synchronisation with the environment. We describe methods for monitoring circadian rhythms in a clinical setting, and how this technology may be used for identifying optimal time windows for interventions, or to alert the physician to a critical deterioration of circadian rhythmicity. We suggest a chronobiological approach to critical illness, involving multicomponent strategies to promote chronofitness (chronobundles), and further investment in the development of personalised, time-based treatment for critically ill patients.

dc.format.extent124-
dc.format.mediumElectronic
dc.languageen
dc.language.isoen
dc.publisherSpringer Science and Business Media LLC
dc.subjectCircadian rhythm
dc.subjectChronobiology
dc.subjectChronotherapy
dc.subjectCritical illness
dc.subjectIntensive care units
dc.titleClinical chronobiology: a timely consideration in critical care medicine
dc.typejournal-article
dc.typeJournal Article
dc.typeReview
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000431905800003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.issue1
plymouth.volume22
plymouth.publication-statusPublished
plymouth.journalCritical Care
dc.identifier.doi10.1186/s13054-018-2041-x
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
plymouth.organisational-group/Plymouth/Users by role/Researchers in ResearchFish submission
dc.publisher.placeEngland
dcterms.dateAccepted2018-04-13
dc.rights.embargodate2020-7-11
dc.identifier.eissn1364-8535
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1186/s13054-018-2041-x
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-12
rioxxterms.typeJournal Article/Review


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