NIRS plays an important role in the clinical care of TBI patients. Regional brain saturation monitoring provides accurate predictive data, which can improve the allocation of scarce medical resources, set the treatment goals and alleviate the early communication with patients' relatives.
Study objective. Heart rate variability (HRV) is an
objective, easy-to-obtain parameter that can be used
to monitor person’s balance of autonomous nervous
system, which in turn decides one’s ability to cope
with stress. HRV has been used extensively in professional
athletes and the military with the purpose
of performance optimisation and burnout prevention.
The aim of our study was to investigate the balance
of EM residents’ autonomic nervous system, as indicated
by fluctuations in day-to-day HRV readings,
and the feasibility of short relaxation techniques to
increase their stress-resilience.
Methods. We conducted a two-month long prospective
cross-over double blinded randomized study.
Computer randomization was used to divide the EM
residents into intervention (A) and control (B) groups.
Controls were instructed to listen to a 12 min. relaxation
audio file every morning, while the intervention
group was equipped with a 12 min. guided
meditation that combined rhythmic breathing and
attention focusing techniques. After one month, crossover
of the interventions took place.
Results. After pooling pre-shift and post-shift HRV
data, we identified differences of statistical significance
with post-shift HRV readings being higher
(p=0.028, p<0,05). Individual HRV trend analysis
showed significant fluctuations in day-to-day HRV
readings. We could not identify the impact of short relaxation
techniques on the EM residents HRV trends.
Conclusion. Our findings suggest the lack of autonomic
nervous system balance among EM residents,
as indicated by big fluctuations in their day-to-day
HRV trends. During the course of the study, the HRV
reading fluctuations did not stabilise, indicating the
limited use of our selected short relaxation techniques
to increase residents’ stress resilience. We also identified
paradoxical findings of higher post-shift HRV
readings which could true be due to unique population
in the setting of EM.
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