• Ming-Cheng Chan, Peter M Spieth, Kieran Quinn, Matteo Parotto, Haibo Zhang, and Arthur S Slutsky.
• Keenan Research Centre at the Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
• Crit. Care Med. 2012 Jan 1; 40 (1): 246-53.

Objective: Circadian rhythms are intrinsic timekeeping mechanisms that allow for adaptation to cyclic environmental changes. Increasing evidence suggests that circadian rhythms may influence progression of a variety of diseases as well as effectiveness and toxicity of drugs commonly used in the intensive care unit. In this perspective, we provide a brief review of the molecular mechanisms of circadian rhythms and its relevance to critical care. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION, AND DATA SYNTHESIS:: Articles related to circadian rhythms and organ systems in normal and disease conditions were searched through the PubMed library with the goal of providing a concise review.Conclusions: Critically ill patients may be highly vulnerable to disruption of circadian rhythms as a result of the severity of their underlying diseases as well as the intensive care unit environment where noise and frequent therapeutic/diagnostic interventions take place. Further basic and clinical research addressing the importance of circadian rhythms in the context of critical care is warranted to develop a better understanding of the complex pathophysiology of critically ill patients as well as to identify novel therapeutic approaches for these patients.

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