Conclusions: Clearly light has the very real potential to alter the course of disease and the behavior of persons providing care. Although we have a deeper understanding of the biological mechanisms involved in the visual and non-visual effects of light, and the psychological and behavioral elements of the complex interaction between light exposure and health outcomes, it is far from complete. There are still many nebulous aspects, and with each step of understanding, several new questions arise, particularly in the context of critical illness. How does illness alter the neural and endocrine pathways governing the biological eff ects of light? Do measures to engage the physiologic and neural feedback loops enhance, hinder, or fail to influence their actions? What are the effects of blue and green light wavelengths in a patient that is sedated and intubated? What happens to the biologic rhythms and immune responses if our critically ill patient rests in a room without windows, even though it is a greatly illuminated one? As artificial light sources in ICUs fail to account for retinal spectral sensitivity and the circadian clock, are our artificially lighted work environments leaving our patients and healthcare providers blue light deprived? Hopefully, for these and many other questions, future studies will enlighten us as to the benefi ts of returning natural light and nature to the bedside.
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