Day-Night Activity in Hospitalized Children after Major Surgery: An Analysis of 2271 Hospital Days.

Objectives: To characterize the day-night activity patterns of children after major surgery and describe differences in children's activity patterns between the pediatric intensive care unit (PICU) and inpatient floor setting.Study Design: In this prospective observational study, we characterized th...

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Publicado en:Journal of Pediatrics Vol. 209; pp. 190 - 191
Autores principales: Kudchadkar, Sapna R., Aljohani, Othman, Johns, Jordan, Leroux, Andrew, Alsafi, Eman, Jastaniah, Ebaa, Gottschalk, Allan, Shata, Nehal J., Al-Harbi, Ahmad, Gergen, Daniel, Nadkarni, Anisha, Crainiceanu, Ciprian
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. Jun2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2019
      vid: 209
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      pub: Elsevier B.V.
      place: New York, New York
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        136419399
        10.1016/j.jpeds.2019.01.054
        NLM30885646
        136419399
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      tig:
        atl: Day-Night Activity in Hospitalized Children after Major Surgery: An Analysis of 2271 Hospital Days.
      aug:
        au:
          Kudchadkar, Sapna R.
          Aljohani, Othman
          Johns, Jordan
          Leroux, Andrew
          Alsafi, Eman
          Jastaniah, Ebaa
          Gottschalk, Allan
          Shata, Nehal J.
          Al-Harbi, Ahmad
          Gergen, Daniel
          Nadkarni, Anisha
          Crainiceanu, Ciprian
        affil: Department of Anesthesiology and Critical Care Medicine, Charlotte R. Bloomberg Children's Center, Johns Hopkins University School of Medicine, Baltimore, MD
      sug:
        subj:
          Surgery, Operative
          Hospitalization
          Circadian Rhythm
          Child
          Time Factors
          Human
          Child, Preschool
          Prospective Studies
          Male
          Accelerometry
          Postoperative Period
          Adolescence
          Infant, Newborn
          Infant
          Female
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Funding Source
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Adolescent: 13-18 years
          Infant, Newborn: birth-1 month
          Infant: 1-23 months
          Male
          Female
      ab: Objectives: To characterize the day-night activity patterns of children after major surgery and describe differences in children's activity patterns between the pediatric intensive care unit (PICU) and inpatient floor setting.Study Design: In this prospective observational study, we characterized the daytime activity ratio estimate (DARE; ratio between mean daytime activity [08:00-20:00] and mean 24-hour activity [00:00-24:00]) for children admitted to the hospital after major surgery. The study sample included 221 infants and children ages 1 day to 17 years admitted to the PICU at a tertiary, academic children's hospital. Subjects were monitored with continuous accelerometry from postoperative day 1 until hospital discharge. The National Health and Nutrition Examination Survey accelerometry data were utilized for normative data to compare DARE in a community sample of US children to hospitalized children.Results: The mean DARE over 2271 hospital days was 57.8%, with a significant difference between the average DARE during PICU days and inpatient floor days (56% vs 61%, P < .0001). The average subject DARE ranged from 43% to 73%. In a covariate-adjusted mixed effects model, PICU location, lower age, orthopedic or urologic surgery, and intubation time were associated with decreased DARE. Hospitalized children had significantly lower DARE than the National Health and Nutrition Examination Survey subjects in all age groups studied, with the largest difference in the youngest PICU group analyzed (6-9 years; 59% vs 75%, P < .0001). A subset analysis of children older than 2 years (n = 144) showed that DARE was <50% on 15% of hospital days.Conclusions: Children hospitalized after major surgery experience disruptions in day-night activity patterns during their hospital stay that may reflect disturbances in circadian rhythm.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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