{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T10:59:20Z","timestamp":1768215560278,"version":"3.49.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015258","name":"Zhejiang Provincial People\u2019s Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015258","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Circadian rhythms are cyclical processes within an organism that develop over time for the organism to better adapt to its environment. Disruption of the circadian rhythm by various factors can have both acute and chronic adverse effects on the health of the organism. Sedated patients in the intensive care unit often have severe circadian rhythm disturbances, in which care-related exogenous factors play an important role.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, a randomized controlled trial design was adopted. Starting from the exogenous factors of nursing, the research objects that met the inclusion criteria were numbered. According to the inclusion order, they were odd numbered into the control group (receiving routine nursing care) and even numbered into the experimental group (receiving diversified nursing intervention). The two groups of research objects were divided into different sedation degree groups according to Richmond Agitation Sedation Scale (RASS) scores, which were divided into RASS 0\u20132 group, RASS -3\u20134 group and RASS -5 group, a total of six groups. The influence of diversified nursing intervention measures on patients\u2019 circadian rhythm was evaluated by measuring the melatonin levels of the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found that for patients with RASS scores of -3 to -4, diversified nursing interventions had a significant effect on melatonin concentrations in the 00:00\u201304:00 period (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05), indicating that diversified nursing interventions had a beneficial role in treating circadian rhythm disorders among sedated ICU patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The circadian rhythm is crucial for critically ill patients and can be improved through diversified nursing interventions. This study provides relevant data for the future treatment of patients presenting with circadian rhythm disorders in the intensive care unit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1655844","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:51:43Z","timestamp":1768204303000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A randomized controlled trial examining the impact of diversified nursing interventions on the circadian rhythm of sedated critically ill patients"],"prefix":"10.3389","volume":"12","author":[{"given":"Mengfei","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aili","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liping","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuangqin","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Nan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1097\/ccm.0000000000001282","article-title":"Circadian rhythm disruption in the critically ill.","volume":"44","author":"Oldham","year":"2016","journal-title":"Crit Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1055\/s-0039-1698394","article-title":"Circadian biology and its importance to intensive care unit care and outcomes.","volume":"40","author":"Gao","year":"2019","journal-title":"Semin Respir Crit Care Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1097\/CCM.0000000000004333","article-title":"Factors disrupting melatonin secretion rhythms during critical illness.","volume":"48","author":"Maas","year":"2020","journal-title":"Crit Care Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.jcrc.2016.12.006","article-title":"Circadian disruption of ICU patients: a review of pathways, expression, and interventions.","volume":"38","author":"Korompeli","year":"2017","journal-title":"J Crit Care."},{"key":"B5","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1038\/s41569-019-0167-4","article-title":"Circadian rhythms and the molecular clock in cardiovascular biology and disease.","volume":"16","author":"Crnko","year":"2019","journal-title":"Nat Rev Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e012388","DOI":"10.1161\/JAHA.119.012388","article-title":"Nocturnal mean arterial pressure rising is associated with mortality in the intensive care unit: a retrospective cohort study.","volume":"8","author":"Li","year":"2019","journal-title":"J Am Heart Assoc."},{"key":"B7","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1007\/s00281-022-00921-z","article-title":"Circadian regulation of innate immunity in animals and humans and implications for human disease.","volume":"44","author":"Poole","year":"2022","journal-title":"Semin Immunopathol."},{"key":"B8","first-page":"1674","article-title":"Research progress of circadian rhythm in critical care.","volume":"19","author":"Qin","year":"2021","journal-title":"Chin Gen Pract Nurs."},{"key":"B9","doi-asserted-by":"publisher","first-page":"820","DOI":"10.3389\/fneur.2020.00820","article-title":"Circadian disruption in critical illness.","volume":"11","author":"Jobanputra","year":"2020","journal-title":"Front Neurol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/s13054-019-2366-0","article-title":"Sleep and circadian rhythm in critical illness.","volume":"23","author":"Telias","year":"2019","journal-title":"Crit Care (Lond Engl)."},{"key":"B11","doi-asserted-by":"publisher","first-page":"3453","DOI":"10.2174\/1381612821666150706105602","article-title":"Disruption of circadian rhythms and delirium, sleep impairment and sepsis in critically ill patients. 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