THE PROGNOSTIC VALUE OF LACTATE AND CIRCADIAN HORMONE RHYTHMS IN ICU PATIENTS WITH SEVERE SEPSIS
Date
2026-05-12
Authors
Roaa AbuZaine
Hadil Askafi
Mohammed Abu Snania
Journal Title
Journal ISSN
Volume Title
Publisher
Deanship of Scientific Research - Al-Quds University
Abstract
Background: Sepsis is a life-threatening dysregulated host response to infection. Since the 1960s, preclinical models have demonstrated that the timing of immune challenge significantly affects mortality, suggesting a critical link between circadian biology and inflammatory pathology. However, clinical translation of these findings remains limited.
Objectives: This study evaluates the prognostic significance of diurnal variations in lactate and circadian hormones (cortisol and melatonin) in severe sepsis patients, assessing their correlation with disease severity scores, inflammatory markers, and mortality.
Methods: This prospective observational study was conducted in a single ICU from January 2023 to October 2024. The cohort included healthy controls (n=5) and septic shock patients (n=10) defined by Sepsis-3 criteria (SOFA >2). Septic patients were stratified by survival status. Blood samples were collected at two circadian time points (early morning and nighttime) to assess diurnal variations. Plasma lactate, cortisol, and melatonin were measured and correlated with clinical severity scores (SOFA, SAPS II, APACHE II) and inflammatory markers (IL-6).