Heart rate variability measures as predictors of in-hospital mortality in ED patients with sepsis

Chen, Wei-Lung; Chen, Jiann-Hwa; Huang, Chien‐Cheng; Kuo, Cheng–Deng; Huang, Ching-Kuei; Lee, Liang-Shong

doi:10.1016/j.ajem.2007.06.016

Cited by 103 publications

(94 citation statements)

References 25 publications

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“…Los pacientes fallecidos mostraron mayor pérdida de la variabilidad, este hallazgo concuerda con Chen y Kuo 37 , quienes demostraron la capacidad predictiva de la VFC en la mortalidad hospitalaria en pacientes con sepsis 37 . El uso de inotrópicos y vasopresores obedeció a protocolos de reanimación actuales 38 , estos pacientes mostraron mayor pérdida de la VFC.…”

Section: Discussionunclassified

Estudio ECAIS: eventos cardiovasculares adversos inadvertidos en sepsis

Duque¹,

Olivera²,

Torres³

et al. 2012

Medicina Intensiva

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PALABRAS CLAVEIsquemia miocárdica; Electrocardiografía ambulatoria; Sepsis; Choque séptico Resumen Objetivo: Describir la incidencia de eventos cardiovasculares adversos en pacientes con diagnóstico de sepsis en sus diferentes estadios. Diseño: Estudio observacional, descriptivo, longitudinal. Ámbito: Unidades de cuidados intensivos de tipo mixto de dos hospitales universitarios en la ciudad de Bogotá. Participantes: Se incluyeron una serie de pacientes mayores de edad, que ingresan a UCI con diagnostico de sepsis, sin evidencia de lesión miocárdica isquémica previa. Intervenciones: Registros electrocardiográficos continuos de 12 derivaciones durante 48 horas con monitoría Holter Variables de interés: Isquemia, arritmia cardiaca, variabilidad de la frecuencia cardiaca. Resultados: Se analizaron 100 pacientes, 62% de los cuales se estadificó como choque sép-tico. El 3% presentó evento cardiovascular adverso de tipo isquémico detectado por Holter y desapercibido por monitoreo convencional. El 46% presentaron un evento de tipo arrít-mico por Holter, comparado con solo un 6% detectado por monitoreo convencional. La mortalidad cruda fue de 40%. El 100% presentó pérdida de la variabilidad de la frecuencia cardiaca. Conclusión: La sepsis en esta experiencia mostró una baja incidencia de eventos cardiovasculares isquémicos. Los eventos arrítmicos, sin embargo, mostraron una incidencia alta. El monitoreo convencional falló en detectar la totalidad de los eventos isquémicos y en mayor proporción los eventos arrítmicos. En esta serie, los eventos cardiovasculares generados por descarga adrenérgica no impactan en la mortalidad.

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Section: Discussionunclassified

Estudio ECAIS: eventos cardiovasculares adversos inadvertidos en sepsis

Duque¹,

Olivera²,

Torres³

et al. 2012

Medicina Intensiva

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“…1,6,11 This may explain differing performances with respect to predictive ability over other frequency domain parameters in the intensive care setting. 3 HRV is increasingly gaining popularity as a predictor of outcome in a variety of clinical environments, including trauma patients, 12 critically ill emergency department 4 patients, 13 septic patients on admission to ED, 14 and the haemodynamically stable trauma patient. 15 It has also been used to predict outcomes such as hypotension during obstetric spinal hypotension.…”

Section: Discussionmentioning

confidence: 99%

Heart rate variability predicts 30-day all-cause mortality in intensive care units

Bishop

Wise

Lee

et al. 2016

Southern African Journal of Anaesthesia and Analgesia

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Background: Autonomic nervous function, as quantified by heart rate variability (HRV), has shown promise in predicting clinically important outcomes in the critical care setting; however, there is debate concerning its utility. HRV analysis was assessed as a practical tool for outcome prediction in two South African hospitals and compared with Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring. Method: In a dual centre, prospective, observational cohort study of patients admitted to the intensive care units (ICU) of two hospitals in KwaZulu-Natal, South Africa frequency domain HRV parameters were explored as predictors of: all-cause mortality at 30 days after admission; ICU stay duration; the need for invasive ventilation; the need for inotrope/vasopressor therapy; and the need for renal replacement therapy. The predictive ability of HRV parameters against the APACHE II score for the study outcomes was also compared. Results: A total of 55 patients were included in the study. Very low frequency power (VLF) was shown to predict 30-day mortality in ICU (odds ratio 0.6; 95% confidence interval 0.396-0.911). When compared with APACHE II, VLF remained a significant predictor of outcome, suggesting that it adds a unique component of prediction. No HRV parameters were predictive for the other secondary outcomes. Conclusion: This study found that VLF independently predicted all-cause mortality at 30 days after ICU admission. VLF provided additional predictive ability above that of the APACHE II score. As suggested by this exploratory analysis larger multi-centre studies seem warranted.

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“…The subjects were divided into three groups by age: group I (n¼ 10; age range, 21-26 years), group II (n¼10; age range, [30][31][32][33][34][35][36][37][38][39], and group III (n¼10; age range, 40-49 years) [23]. The subjects had no reported heart-related or internal diseases.…”

Section: Subjectsmentioning

confidence: 99%