SynthesisFrontiers in neurology2026
Effectiveness of combined versus single circadian interventions in neonatal and pediatric intensive care units: a systematic review with meta-analysis.
Synthesis in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Admission to neonatal or pediatric intensive care units exposes vulnerable patients to confounding environmental cues, disrupting circadian rhythms and potentially compromising physiological stability. While various circadian interventions exist, ranging from simple light cycling to complex multicomponent bundles, it remains unclear whether complex bundles offer superior clinical benefits over single-modality interventions. This systematic review evaluated the efficacy of circadian interventions on physiological parameters and sleep primarily in critically ill neonates and children, specifically comparing single versus combined strategies. Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. We searched five major electronic databases: PubMed, ScienceDirect, CINAHL, WoS, Scopus and LILACS. Additionally, the Epistemonikos and SciELO databases were screened to identify relevant studies published in languages other than English. The search covered from inception to 2025 and was conducted during October 2025. Risk of bias was assessed using the Cochrane RoB 2 tool and ROBINS-I, while the certainty of evidence was evaluated using the GRADE approach. Data were synthesized using random-effects meta-analysis for physiological outcomes and SWiM guidelines for studies with non-parametric or incompatible data. Results: Forty-one studies ( Conclusion: Circadian interventions are effective strategies for modulating physiological parameters and improving sleep quality in the NICU. Single interventions, such as cycled lighting, yielded similar outcomes to complex multicomponent bundles, but due to the lack of pediatric research, our results should be interpreted with caution. Future research should prioritize primary research in pediatric settings to deepen our understanding about circadian interventions. Systematic review registration: https://doi.org/10.17605/OSF.IO/8SPZM, Identifier: CRD4201091137.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.