In:
Cardiology Research and Practice, Hindawi Limited, Vol. 2018 ( 2018), p. 1-8
Kurzfassung:
Background. Reduced heart rate variability (HRV) indicates dominance of the sympathetic system and a state of “physiologic stress.” We postulated that, in patients with critical illness, increases in HRV might signal successful resuscitation and improved prognosis. Methods . We carried out a prospective observational study of HRV on all patients referred to the rapid response team (RRT) and correlated with serial vital signs, lactate clearance, ICU admission, and mortality. Results . Ninety-one patients were studied. Significantly higher HRV was observed in patients who achieved physiological stability and did not need ICU admission: ASDNN 19 versus 34.5, p = 0.032 ; rMSSD 13.5 versus 25, p = 0.046 ; mean VLF 9.4 versus 17, p = 0.021 ; mean LF 5.8 versus 12.4, p = 0.018 ; and mean HF 4.7 versus 10.5, p = 0.017 . ROC curves confirmed the change in very low frequencies at 2 hours as a strong predictor for ICU admission with an AUC of 0.772 (95% CI 0.633, 0.911, p = 0.001 ) and a cutoff value of −0.65 associated with a sensitivity of 78.6% and a specificity of 61%. Conclusions . Reduced HRV, specifically VLF, appears closely related to greater severity of critical illness, identifies unsuccessful resuscitation, and can be used to identify consultations that need early ICU admission.
Materialart:
Online-Ressource
ISSN:
2090-8016
,
2090-0597
DOI:
10.1155/2018/1590217
Sprache:
Englisch
Verlag:
Hindawi Limited
Publikationsdatum:
2018
ZDB Id:
2506187-2
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