Authors: Pedro I. Medina¹, Felix G. Delgado¹, Jaime R. Marrero BS¹, Anabel Puig PhD², José L. Agosto PhD¹

Affiliations: 1 University of Puerto Rico – Río Piedras Campus, 2 University of Puerto Rico – Medical Sciences Campus

Introduction: Asthma is a chronic disease of the respiratory system that affects 1 in 12 children in the US yearly. It is characterized by inflammation and narrowing of the respiratory tract, and can be severe enough to require intensive care in over 30% of diagnosed children. We propose that a possible indicator of the severity of disease may be the level of synchrony between circadian oscillators, where patients with a higher level of desynchrony require more care and a longer stay in the Pediatric Intensive Care Unit (PICU).

Methods: This study consists of a retrospective analysis of vital sign data, gathered from the PICU in San Jorge Children’s hospital. The analyzed population consisted of patients between the age of 4 and 21 with an official diagnosis of asthma, and who were later released after treatment for that disease. Vital sign readings, such as temperature, were evaluated with circadian analysis software to determine oscillation patterns.

Results: Our analysis seeks to examine the circadian marker of temperature for all patients. Each patient must have a stay of a minimum of three days to be able to determine the presence of oscillations. We expect to find that patients with a shorter stay will have more stable oscillations in their circadian markers to begin with. Patients with a longer stay are expected to have more desynchrony in their rhythms, improving as they are closer to being discharged. 

Conclusions: Once analysis for the circadian marker of temperature has been finalized, it is expected that there will be an association between desynchrony and length of stay in the PICU. The same analysis will be carried out for other circadian markers, to examine the possibility of treatment options targeting circadian rhythm desynchrony to reduce the length of stay.

Acknowledgements: This work is made possible by collaboration with San Jorge Children’s Hospital. I thank my PI, Graduate student, and lab members for their support.

Keywords: Asthma, Circadian Rhythm, Circadian Analysis, Temperature as a marker