Heart rate variability as a marker and predictor of inflammation, nosocomial infection, and sepsis – A systematic review

Adam, Josephine; Rupprecht, Sven; Künstler, Erika C.S.; Hoyer, Dirk

doi:10.1016/j.autneu.2023.103116

Cited by 5 publications

(5 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In both non-COVID and COVID populations, HF HP and σ 2 SAP were similar in SURVs and non-SURVs, and they were not affected by MHUT. Regardless of the experimental condition, we observed a tendency towards higher values of HF HP in SURVs compared to non-SURVs in both populations, thus suggesting that having a greater vagal modulation might be a protective factor [7,8,19,49]. Regardless of the experimental condition, we observed a tendency of σ 2 SAP towards larger values in non-SURVs compared to SURVs in both populations, thus suggesting that uncontrolled fluctuations of SAP have a negative impact on the survival rate [21,51].…”

Section: Association Of Autonomic Markers Of Non-covid-19 and Covid-1...mentioning

confidence: 62%

“…However, the tendency toward lower BRS LF and K 2 LF both at REST and during MHUT in non-SURVs suggests that a less active baroreflex control might be a negative prognostic factor. We suggest that SURVs within the COVID-19 group might have more powerful internal regulatory resources to limit the progress of inflammation, prevent exaggerated immune responses and avoid the development of arrhythmic events [1,8,11,12,22,49,51]. The more limited activity of the cardiac arm of the baroreflex might contribute to the worse prognosis associated with small HP variations in critically ill COVID-19 patients [1,7,8,19,20].…”

Section: Association Of Baroreflex Control Markers Of Non-covid-19 An...mentioning

confidence: 92%

“…Given that the cardiac arm of the baroreflex is a vagal reflex dramatically limited by a complete cholinergic blockade [15], we speculate that vagal control of COVID-19 individuals was more pronounced than in non-COVID-19 individuals. It is unknown whether this phenomenon could be a response to hyperinflammation in the attempt of blunting it in the context of a COVID-19 cytokine storm [1,8,11,12,49]. The marked vagal control in COVID-19 patients may be driven by pulmonary afferences triggered by COVID-19-induced pneumonia.…”

Section: Baroreflex Control Of Non-covid-19 and Covid-19 Patients Adm...mentioning

confidence: 99%

See 2 more Smart Citations

Autonomic Function and Baroreflex Control in COVID-19 Patients Admitted to the Intensive Care Unit

Gelpi,

Wu,

Bari

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Autonomic function and baroreflex control might influence the survival rate of coronavirus disease 2019 (COVID-19) patients admitted to the intensive care unit (ICU) compared to respiratory failure patients without COVID-19 (non-COVID-19). This study describes physiological control mechanisms in critically ill COVID-19 patients admitted to the ICU in comparison to non-COVID-19 individuals with the aim of improving stratification of mortality risk. Methods: We evaluated autonomic and baroreflex control markers extracted from heart period (HP) and systolic arterial pressure (SAP) variability acquired at rest in the supine position (REST) and during a modified head-up tilt (MHUT) in 17 COVID-19 patients (age: 63 ± 10 years, 14 men) and 33 non-COVID-19 patients (age: 60 ± 12 years, 23 men) during their ICU stays. Patients were categorized as survivors (SURVs) or non-survivors (non-SURVs). Results: We found that COVID-19 and non-COVID-19 populations exhibited similar vagal and sympathetic control markers; however, non-COVID-19 individuals featured a smaller baroreflex sensitivity and an unexpected reduction in the HP-SAP association during the MHUT compared to the COVID-19 group. Nevertheless, none of the markers of the autonomic and baroreflex functions could distinguish SURVs from non-SURVs in either population. Conclusions: We concluded that COVID-19 patients exhibited a more preserved baroreflex control compared to non-COVID-19 individuals, even though this information is ineffective in stratifying mortality risk.

show abstract

Section: Association Of Autonomic Markers Of Non-covid-19 and Covid-1...mentioning

confidence: 62%

Section: Association Of Baroreflex Control Markers Of Non-covid-19 An...mentioning

confidence: 92%

Section: Baroreflex Control Of Non-covid-19 and Covid-19 Patients Adm...mentioning

confidence: 99%

See 1 more Smart Citation

Autonomic Function and Baroreflex Control in COVID-19 Patients Admitted to the Intensive Care Unit

Gelpi,

Wu,

Bari

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…Diagnosing neonatal sepsis and starting antibiotics is challenging in clinical practice, which emphasizes the need for a comprehensive approach. Previous studies have explored the role of heart rate variability in predicting early-onset sepsis with an accuracy of 64-94% [84]. Also, regarding the detection of late-onset sepsis, ML decision algorithms have utilized clinical and laboratory biomarkers obtaining an optimal accuracy and a mean precision rate of 0.82 3 hours before the onset of sepsis [76].…”

Section: Sepsismentioning

confidence: 99%

Current Applications of Artificial Intelligence in the Neonatal Intensive Care Unit

Rallis,

Baltogianni,

Kapetaniou

et al. 2024

Preprint

View full text Add to dashboard Cite

Artificial intelligence (AI) refers to computer algorithms that replicate the cognitive function of humans. Machine learning is widely applicable using structured and unstructured data, while deep learning is derived from the neural networks of the human brain that process and interpret information. During the last decades, AI has been introduced in several aspects of healthcare. In this review, we aim to present the current application of AI in the neonatal intensive care unit. AI-based models have been applied to neurocritical care, including automated seizure detection algorithms and electroencephalogram-based hypoxic-ischemic encephalopathy severity grading systems. Moreover, AI models evaluating magnetic resonance imaging contributed to the progress of the evaluation of the neonatal developing brain and the understanding of how prenatal events affect both structural and functional network topologies. Furthermore, AI algorithms have been applied to predict the development of bronchopulmonary dysplasia and assess the extubation readiness of preterm neonates. Automated models have been also used for the detection of retinopathy of prematurity and the need for treatment. Among others, AI algorithms have been utilized for the detection of sepsis, the need for patent ductus arteriosus treatmnet, the evaluation of jaundice, and the detection of gastrointestinal morbidities. Finally, AI prediction models have been constructed for the evaluation of the neurodevelopmental outcome and the overall mortality of neonates. Although the application of AI in neonatology is encouraging, further research in AI models is warranted in the future including retraining clinical trials, validating the outcomes, and addressing serious ethics issues.

show abstract

“…Proinflammatory states are linked to reduced HRV. 17 For example, Euteneuer et al 18 demonstrated that patients with major depressive disorder (MDD) exhibit higher levels of C reactive protein (CRP), interleukin (IL)-6 and tumour necrosis factor-α (TNFα), alongside reduced 24 hours and daytime HRV. What is worse, autonomic nervous system (ANS) dysfunction and inflammatory response contribute to higher cardiac mortality in patients with depression.…”

Section: Open Accessmentioning

confidence: 99%

Meta-analysis on inflammation and autonomic nervous system of coronary heart disease combined with depression

Li,

Zhang,

Liu

2024

BMJ Open

View full text Add to dashboard Cite

ObjectivesThis meta-analysis aimed to explore the association between inflammatory factors, heart rate variability (HRV) and the coexistence of coronary heart disease (CHD) and depression.DesignSystematic review and meta-analysis. Complying with the Meta-analysis Of Observational Studies in Epidemiology statement.Data sourcesWe searched PubMed, Web of Science and EMBASE for the data from the inception date to 16 March 2023.Eligibility criteriaWe included cross-sectional and cohort studies with inclusion criteria: (1) patients with CHD; (2) depression measurement and (3) including inflammatory factors or cardiac biomarkers or HRV.Data extraction and synthesisTwo authors searched the databases independently. The effect estimates and heterogeneity were synthesised by Review Manager V.5.3. Sensitivity analysis and publication bias were analysed by STATA software. The quantitative synthesis outcomes were presented by mean difference (MD) or standard MD (SMD) with 95% CI.ResultsBy searching the databases, we identified a total of 6750 articles. There were 22 articles left after selection, including 6344 participants. This meta-analysis indicated that patients with CHD with depression had higher levels of C reaction protein (CRP) (SMD 0.50, 95% CI (0.19 to 0.81), p=0.001), high-sensitivity C reactive protein (hs-CRP) (SMD 0.28, 95% CI (0.07 to 0.48), p=0.008), IL-6 (SMD 0.49, 95% CI (0.05 to 0.92), p=0.03) and a lower level of the mean RR interval and the SD of all RR intervals (SMD −0.64, 95% CI (−1.11 to –0.17), p=0.008), SD of the 5 min averages of all normal RR intervals (MD −12.77 ms, 95% CI (–21.20 to –4.33), p=0.003), overage of the SD of all normal RR intervals for each 5 min segment (MD −13.83 ms, 95% CI (–15.94 to –11.72), p<0.00001), root mean square of successive differences (MD: −8.02 ms, 95% CI (–13.62 to –2.43), p=0.005), proportion of adjacent cycles differing by >50 ms (pNN50) (SMD −0.86, 95% CI (−1.41 to –0.31), p=0.002), than those without depression.ConclusionsThis study underscores the association between elevated CRP, hs-CRP, IL-6 and lower HRV in patients with CHD with depression. It emphasises the importance of clinicians assessing CRP, hs-CRP, IL-6 and HRV in patients with CHD to potentially identify depressive conditions.

show abstract

Heart rate variability as a marker and predictor of inflammation, nosocomial infection, and sepsis – A systematic review

Cited by 5 publications

References 87 publications

Autonomic Function and Baroreflex Control in COVID-19 Patients Admitted to the Intensive Care Unit

Autonomic Function and Baroreflex Control in COVID-19 Patients Admitted to the Intensive Care Unit

Current Applications of Artificial Intelligence in the Neonatal Intensive Care Unit

Meta-analysis on inflammation and autonomic nervous system of coronary heart disease combined with depression

Contact Info

Product

Resources

About