Increases in Heart Rate Variability Signal Improved Outcomes in Rapid Response Team Consultations: A Cohort Study
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 prospect...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/1590217 |
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| author | Nawal Salahuddin Azam Shafquat Qussay Marashly Khaled Juan Zaza Moh’d Sharshir Moazzum Khurshid Zeeshan Ali Melissa Malgapo Mouhamad Ghyath Jamil Mohamed Shoukri Mohammed Hijazi Bandar Al-Ghamdi |
| author_facet | Nawal Salahuddin Azam Shafquat Qussay Marashly Khaled Juan Zaza Moh’d Sharshir Moazzum Khurshid Zeeshan Ali Melissa Malgapo Mouhamad Ghyath Jamil Mohamed Shoukri Mohammed Hijazi Bandar Al-Ghamdi |
| author_sort | Nawal Salahuddin |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-de82090249984b518f8bc3b297c3caab |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-de82090249984b518f8bc3b297c3caab2025-08-20T03:26:16ZengWileyCardiology Research and Practice2090-80162090-05972018-01-01201810.1155/2018/15902171590217Increases in Heart Rate Variability Signal Improved Outcomes in Rapid Response Team Consultations: A Cohort StudyNawal Salahuddin0Azam Shafquat1Qussay Marashly2Khaled Juan Zaza3Moh’d Sharshir4Moazzum Khurshid5Zeeshan Ali6Melissa Malgapo7Mouhamad Ghyath Jamil8Mohamed Shoukri9Mohammed Hijazi10Bandar Al-Ghamdi11Department of Critical Care Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi ArabiaSection of Electrophysiology, Heart Center, King Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi ArabiaCollege of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi ArabiaCollege of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi ArabiaDepartment of Critical Care Medicine, king Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi ArabiaDepartment of Critical Care Medicine, king Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi ArabiaDepartment of Critical Care Medicine, king Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi ArabiaDepartment of Nursing, King Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi ArabiaDepartment of Critical Care Medicine, king Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi ArabiaNational Biotechnology Center, King Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi ArabiaDepartment of Critical Care Medicine, king Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi ArabiaSection of Electrophysiology, Heart Center, King Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi ArabiaBackground. 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.http://dx.doi.org/10.1155/2018/1590217 |
| spellingShingle | Nawal Salahuddin Azam Shafquat Qussay Marashly Khaled Juan Zaza Moh’d Sharshir Moazzum Khurshid Zeeshan Ali Melissa Malgapo Mouhamad Ghyath Jamil Mohamed Shoukri Mohammed Hijazi Bandar Al-Ghamdi Increases in Heart Rate Variability Signal Improved Outcomes in Rapid Response Team Consultations: A Cohort Study Cardiology Research and Practice |
| title | Increases in Heart Rate Variability Signal Improved Outcomes in Rapid Response Team Consultations: A Cohort Study |
| title_full | Increases in Heart Rate Variability Signal Improved Outcomes in Rapid Response Team Consultations: A Cohort Study |
| title_fullStr | Increases in Heart Rate Variability Signal Improved Outcomes in Rapid Response Team Consultations: A Cohort Study |
| title_full_unstemmed | Increases in Heart Rate Variability Signal Improved Outcomes in Rapid Response Team Consultations: A Cohort Study |
| title_short | Increases in Heart Rate Variability Signal Improved Outcomes in Rapid Response Team Consultations: A Cohort Study |
| title_sort | increases in heart rate variability signal improved outcomes in rapid response team consultations a cohort study |
| url | http://dx.doi.org/10.1155/2018/1590217 |
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