Melatonin Use in Pediatric Intensive Care Units: A Single-Center Experience

Area of Science:

• Pediatric Critical Care Medicine
• Sleep Medicine
• Pharmacology

Background:

• Altered melatonin secretion is linked to sleep disturbances, delirium, and impaired recovery in critical illness.
• Limited research exists on melatonin's role in pediatric critical care settings.

Purpose of the Study:

• To determine the frequency and indications for melatonin prescription in a tertiary pediatric intensive care unit (PICU).
• To analyze the impact of melatonin use on patient outcomes, including length of stay.

Main Methods:

• Retrospective review of 5-year data from a tertiary PICU.
• Analysis of pediatric patients (0-18 years) prescribed melatonin.
• Data collected included initiation day, dose, frequency, duration, and length of stay.

Main Results:

• Melatonin was prescribed to 6.0% of admitted patients (n=182).
• Most patients (46%) received melatonin as a continuation of home medication, with significantly earlier initiation and reduced length of stay (7.2 ± 9.3 days).
• Clear documentation of indication was absent in 20% of cases.

Conclusions:

• Melatonin use in PICUs is infrequent, with continuation of home medication being the primary indication.
• Strategic and documented approaches to melatonin administration in critically ill children may optimize outcomes.
• Further research is warranted to establish evidence-based guidelines for melatonin use in pediatric critical care.