1406 Nocturnal Melatonin Concentration in Pediatric Intensive Care Patients with Sepsis

Introduction: Considering the potential immunomodulatory role of melatonin and its direct antioxidant activity, disturbances of the melatonin secretion pattern in the septic conditions could be particularly unfavorable. The aim of this study was to evaluate the nocturnal melatonin concentration (NMC) in children with sepsis at the pediatric intensive care unit (PICU). Material and Methods: This observational study involved 15 septic and 14 non-septic patients at the PICU, University of Cukurova, Adana, Turkey. An eye mask was used between 8pm and 8am in all patients. Blood samples for the determination of NMC were obtained from each patient at 3 am on day 1, 2, 3, 5 and 10. Results: The median NMCs were not significantly different between septic and non-septic patients: Median(IQR), 89.6pg/ml (39.1-168.9pg/ml) and 61.3pg/ml (28.5-133.5pg/ml); 102.2pg/ml (50.0- 441.2pg/ml) and 59.0pg/ml (16.4-293.0pg/ml); 73.8pg/ml (39.7-406.2pg/ml) and 97.0pg/ml (26.5- 154.2pg/ml); 78.1pg/ml (38.6-179.3pg/ml) and 153.4pg/ml (45.5-231.1pg/ml); 86.8pg/ml (21.1- 137.5pg/ml) and 120.6pg/ml (17.0-208.3pg/ml) at day 1, 2, 3, 5 and 10, respectively (p>0.05). The septic patients showed no significant changes of NMCs between day1 and each other study day (p>0.05). Presence of catecholamine, sedation and mechanical ventilation had no effect on the NMCs in septic patients (p>0.05). There was no correlation between severity of disease (PRISM-II-Score) and NMC on day 1 (p>0.05). Conclusion: The present study showed that the NMC is not affected in septic PICU patients despite severe disease and it is independent of the treatment. Further investigations are needed to identify any additional benefits of the treatment with melatonin in PICU patients with sepsis.