Decomplexification in critical illness and injury: Relationship between heart rate variability, severity of illness, and outcome
Critical Care MedicinePublished 1 February 1998
Brahm Goldstein, Debra H. Fiser, Mary M. Kelly, Deanne Mickelsen, Urs E. Ruttimann, Murray M. Pollack
Citations184
SJR quartileQ1
SJR score2.12
SNIP2.15
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The hypothesis that measures of heart rate power spectra are inversely related and negatively correlated to severity of illness and outcome in critically ill and injured children is supported.
Abstract
Our data support the hypothesis that measures of heart rate power spectra are inversely related and negatively correlated to severity of illness and outcome in critically ill and injured children. The phenomenon of decomplexification of physiologic dynamics may have important clinical implications in critical illness and injury.
Keywords
MedicineEngineering
SciencePower Spectrum Analysis of Heart Rate Fluctuation: A Quantitative Probe of Beat-to-Beat Cardiovascular Control
5,081 Citations1981S. Akselrod, David Gordon +4 more
It is shown that sympathetic and parasympathetic nervous activity make frequency-specific contributions to the heart rate power spectrum, and that renin-angiotensin system activity strongly modulates the amplitude of the spectral peak located at 0.04 hertz.
CirculationCardiovascular neural regulation explored in the frequency domain.
3,568 Citations1991Alberto Malliani, M. Pagani +2 more
It is the opinion that rhythms and neural components always interact, just like flexor and extensor tones or excitatory and inhibitory cardiovascular reflexes, and that it is misleading to separately consider vagal and sympathetic modulations of heart rate.
CirculationFrequency domain measures of heart period variability and mortality after myocardial infarction.
1,722 Citations1992J. Thomas Bigger, Joseph L. Fleiss +4 more
The relation between the heart period variability measures and all-cause mortality, cardiac death, and arrhythmic death before and after adjusting for five previously established postinfarction risk predictors is explored.
Critical Care MedicinePediatric risk of mortality (PRISM) score
1,393 Citations1988Murray M. Pollack, Urs E. Ruttimann +1 more
The Pediatric Risk of Mortality (PRISM) score was developed from the Physiologic Stability Index (PSI) to reduce the number of physiologic variables required for pediatric ICU (PICU) mortality risk assessment and to obtain an objective weighting of the remaining variables.
The Journal of PediatricsAssessing the outcome of pediatric intensive care
899 Citations1992Debra H. Fiser
The POPC and PCPC scales are apparently reliable and valid tools for assessing the outcome of pediatric intensive care.
The American Journal of CardiologyAssessment of autonomic regulation in chronic congestive heart failure by heart rate spectral analysis
710 Citations1988J. Philip Saul, Yutaka Arai +4 more
The frequency characteristics of HR fluctuations in patients with severe CHF are consistent with abnormal baroreflex responsiveness to physiologic stimuli, and suggest that there is diminished vagal, but relatively preserved sympathetic, modulation of HR.
Journal of HypertensionSympathetic predominance an essential hypertension: a study employing spectral analysis of heart rate variability
417 Citations1988Stefano Guzzetti, Emanuela Piccaluga +5 more
Critical Care MedicineUncoupling of biological oscillators
383 Citations1996Paul Godin, Timothy G. Buchman
It is suggested that healthy organs behave as biological oscillators, which couple to one another during human development, and that this orderly coupling is maintained through a communications network, including neural, humoral, and cytokine components.
Critical Care MedicineExperimental human endotoxemia increases cardiac regularity
229 Citations1996Paul Godin, Lee A. Fleisher +6 more
Infusion of endotoxin into human volunteers causes loss of heart rate variability, as measured by standard deviation and power spectra, as well as an increase in heart rate regularity, as Measure of regularity occurred earlier than changes in otherheart rate variability measures and may be a useful means of detecting early sepsis.
CirculationPower spectrum analysis of heart rate variability in human cardiac transplant recipients.
223 Citations1989Kenneth Sands, M.L. Appel +4 more
It is concluded that denervation of the heart significantly reduces heart rate variability and abolishes the discrete spectral peaks seen in untransplanted control subjects and that the development of allograft rejection may significantly increaseheart rate variability.
Journal of the Autonomic Nervous SystemSpectral analysis of heart rate fluctuations. A non-invasive, sensitive method for the early diagnosis of autonomic neuropathy in diabetes mellitus
200 Citations1987Michael Lishner, S. Akselrod +4 more
A marked reduction in the power of heart rate fluctuations, at all frequencies, was found in the diabetic patients as compared to controls, which indicates a depression of both parasympathetic and sympathetic activity.
Journal of Surgical ResearchSpectral Analysis of Heart Rate Variability in the ICU: A Measure of Autonomic Function
183 Citations1996Robert J. Winchell, David B. Hoyt
It is concluded that serial spectral analysis of HRV is practical in an ICU setting and that HRV parameters appear to be a clinically relevant indication of autonomic activity.
The Nephron journals/Nephron journalsSpectral Analysis of Fluctuations in Heart Rate: An Objective Evaluation of Autonomic Nervous Control in Chronic Renal Failure
158 Citations2008Steve Axelrod, Michael Lishner +3 more
Spectral analysis of HR fluctuations in RF patients makes it possible to quantitate autonomic dysfunction and to reliably measure its development as a function of time, and requires only a 10-min standard electrocardiogram recording.
Clinical Autonomic ResearchSpectral analysis of heart rate variability in the sepsis syndrome
149 Citations1993Christopher S. Garrard, Dimitrios A. Kontoyannis +1 more
During the sepsis syndrome, total heart rate variability and the sympathetically mediated component, LFPn were significantly lower than during the following recovery phase (ANOVA, p < 0.0001).
American Journal of Physiology-Cell PhysiologyGestational change in Na+ and Ca2+ channel current densities in rat myometrial smooth muscle cells
132 Citations1991Yuichi Inoue, N. Sperelakis
The results suggest that the role of fast Na+ channels in myometrial activity becomes more and more important as term approaches, and it is suggested that thefast Na+ current may be involved in spread of excitation.
Pediatric ResearchHow the Cell Copes with Stress and the Function of Heat Shock Proteins
103 Citations1994Milton J. Schlesinger
Cells that have been mildly prestressed so that they contain significant levels of the heat shock proteins become tolerant to stress conditions that would normally kill the cell, and organisms survive environmental conditions that might otherwise prove fatal.
American Journal of Physiology-Cell PhysiologyEffect of norepinephrine on Na(+)-K+ pump and Na+ influx in sheep cardiac Purkinje fibers
103 Citations1990Soo‐Wan Chae, D. Y. Wang +2 more
The results suggest that the decrease in aiNa and hyperpolarization in membrane potential by Cs+ are caused by blockage of if but not by stimulation of the Na(+)-K+ pump and that if is an important source of Na+ loading into cells.
Intensive Care MedicineAutonomic control of the heart and peripheral vessels in human septic shock
99 Citations1995Massimo Piepoli, C. S. Garrard +2 more
Reduced LF components of the variability of cardiovascular signals are characteristic of septic shock, confirming the presence of abnormal autonomic control and restored sympathetic (LF) modulation seems to be associated with a favourable prognosis.
HypertensionMild hypovolemic stress alters autonomic modulation of heart rate.
88 Citations1993John K. Triedman, R.J. Cohen +1 more
Transfer function analysis can detect changes in autonomic response to mild degrees of central hypovolemia, which are insufficient to cause changes in mean heart rate or heart rate variance, and represents evidence for modulation of heart rate control by cardiopulmonary baroreceptors.
Critical Care MedicineAutonomic control of heart rate after brain injury in children
82 Citations1996Brahm Goldstein, Mark H. Kempski +5 more
The results imply that autonomic nervous system control of heart rate is disrupted in proportion to the degree of neurologic insult in children after acute brain injury and heart rate power spectral analysis and plasma catecholamine concentrations may prove to be useful adjuncts in determining severity of Neurologic injury and prognosis for recovery in children suffering from brain injury.
Critical Care MedicineAutonomic modulation of heart rate variability during endotoxin shock in rabbits
70 Citations1995Brahm Goldstein, Mark H. Kempski +8 more
Sympathetic modulation of cardiac activity decreased, while the sympathomedullary response remained unchanged during endotoxin shock, and it is speculated that a concomitant decrease in low-frequency HR power as MAP decreases may prove to be an early marker for impending shock.
Physiologic Stability and Physiologic State
69 Citations1996Timothy G. Buchman
If the stability of selected disease states derives from nonlinear interactions among cells, tissues, and organs, then some therapies aimed at supporting or normalizing performance of specific organs may be misdirected.
Critical Care MedicineAutonomic cardiovascular state after severe brain injury and brain death in children
68 Citations1993Brahm Goldstein, Donna E. Deking +6 more
The results support the concept of a damaged sympathetic cardiovascular system in severe brain injury and complete interruption of the autonomic cardiovascular pathways in brain death and have implications for corroborating brain death using autonomiciovascular testing.
Clinics in PerinatologyPhysiology and Clinical Use of Fetal Heart Rate Variability
52 Citations1982Chester B. Martin
The physiologic, pathophysiologic, and clinical factors affecting fetal heart rate variability are concentrated on in this article, since they provide the basis for applying the empirical observations in individual clinical situations.
Acta Physiologica ScandinavicaRespiratory sinus arrhythmia is reversed during positive pressure ventilation
46 Citations1991Arvi Yli‐Hankala, Timo Porkkala +3 more
Inter-individual variation in the magnitude and phase relationship of respiratory sinus arrhythmia was considerable, and was not associated to the level of anaesthesia.
Pediatric ResearchHeart Rate Power Spectrum and Plasma Catecholamine Levels after Postural Change and Cold Pressor Test
43 Citations1994Brahm Goldstein, Paul D. Woolf +4 more
It is concluded that low-frequency heart rate power and plasma catecholamine levels are significantly affected by physiologic changes but arc likely regulated by different areas within the sympathetic nervous system.
Critical Care ClinicsAssessing Perfusion Failure During Circulatory Shock
35 Citations1993Mark E. Astiz, Eric C. Rackow
Tonometrically measured gastric intramucosal pH appears to be a useful method for monitoring splanchnic hypoperfusion and may have implications for assessing global perfusion failure.
Journal of Perinatal MedicineClinical significance of short-term variability computed from heart-rate waveforms
15 Citations1983Debabrata Maulik, Vasant D. Saini +1 more
A retrospective clinical evaluation of a new technique of STV quantification in terms of beats per minute derived from the slowly varying instantaneous FHR waveform rather than from the relatively rapidly varying fetal ECG is presented.
