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Related Experiment Video

Updated: Dec 3, 2025

Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics
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Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics

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Metabolomics Pilot Study Identifies Desynchronization of 24-H Rhythms and Distinct Intra-patient Variability Patterns

Elizabeth R Lusczek1, Lee S Parsons2, Jesse Elder3

  • 1Department of Surgery, University of Minnesota, Minneapolis, MN, United States.

Frontiers in Neurology
|October 30, 2020
PubMed
Summary

Intensive care unit (ICU) patients exhibit significant circadian rhythm desynchronization compared to healthy individuals. This disruption affects vital signs and plasma metabolites, indicating a global disordering of the circadian system and metabolism in ICU patients.

Keywords:
ICU—intensive care unitcircadian rhythmscortisol (Cor)critical illnessmetabolomicsprecision medicine

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Area of Science:

  • Chronobiology
  • Critical Care Medicine
  • Metabolomics

Background:

  • Synchronized circadian rhythms are vital for physiological health; desynchronization can indicate or predispose to disease.
  • Intensive care unit (ICU) environments and patient pathophysiology likely disrupt these rhythms.
  • This study investigated 24-hour rhythm alterations in ICU patients versus healthy controls.

Purpose of the Study:

  • To determine if 24-hour rhythms in vital signs and plasma metabolites are altered in ICU patients.
  • To compare circadian rhythmicity between ICU patients and healthy controls.
  • To explore the potential of metabolomics in tracking patient clinical courses.

Main Methods:

  • Monitored 5 healthy controls and 5 ICU patients for 24 hours.
  • Measured heart rate, blood pressure, temperature, and bedside sound levels.
  • Collected plasma samples every 4 hours for metabolomic analysis using mass spectrometry.
  • Evaluated 24-hour rhythms using the cosinor method and principal component analysis.

Main Results:

  • ICU patient rooms were significantly louder than controls, exceeding EPA recommendations.
  • Healthy controls showed significant group 24-hour rhythms; ICU patients did not, except for cortisol.
  • Plasma metabolomic profiles clustered distinctly by individual ICU patients, separate from controls.
  • Significant desynchronization of vital signs and metabolites was observed in ICU patients.

Conclusions:

  • ICU patients display significant 24-hour circadian rhythm desynchronization compared to healthy individuals.
  • Distinct plasma metabolic profiles in ICU patients suggest metabolomics can longitudinally track clinical courses.
  • Results indicate a global disordering of metabolism and the circadian system in ICU patients, warranting further investigation for clinical implications.