Article

Heart rate variability for evaluating surgical stress and development of postoperative complications.

Department of Surgery, National Hospital Organization Takamatsuhigashi National Hospital 8, Otsu, Shinden, Takamatsu, Kagawa, Japan.
Clinical and Experimental Hypertension (impact factor: 1.07). 02/2008; 30(1):45-55. DOI:10.1080/10641960701813908 pp.45-55
Source: PubMed

ABSTRACT Heart rate variability (HRV) has recently been used to detect autonomic nerve tone, which is affected by various stresses. To test out hypothesis that HRV can determine surgical stress, we examined perioperative HRV in 30 patients with surgical treatment. Relations between HRV and factors of surgical stresses, such as duration of the operation, amount of blood loss at the operation, and developments of complications, were evaluated. Mean heart rate (HR) increased and other HRV indices decreased postoperatively. Most indices correlated significantly to the duration of the operation and amount of blood loss at the operation on postoperative day 1. Only the standard deviation of normal to normal RR intervals (SDNN) and HRV triangular index showed significantly low values in complicated patients. HRV measurement in the perioperative period showed a significant relation to surgical stress. The present results indicated that HRV may provide useful information with respect to surgical stress.

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    Article: Heart rate variability: a diagnostic and prognostic tool in anesthesia and intensive care
    A. T. MAZZEO, E. LA MONACA, R. DI LEO, G. VITA, L. B. SANTAMARIA
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    ABSTRACT: The autonomic nervous system (ANS) plays an important role in the human response to various internal and external stimuli, which can modify homeostasis, and exerts a tight control on essential functions such as circulation, respiration, thermoregulation and hormonal secretion. ANS dysfunction may complicate the perioperative course in the surgical patient undergoing anesthesia, increasing morbidity and mortality, and, therefore, it should be considered as an additional risk factor during pre-operative evaluation. Furthermore, ANS dysfunction may complicate the clinical course of critically ill patients admitted to intensive care units, in the case of trauma, sepsis, neurologic disorders and cardiovascular diseases, and its occurrence adversely affects the outcome. In the care of these patients, the assessment of autonomic function may provide useful information concerning pathophysiology, risk stratification, early prognosis prediction and treatment strategies. Given the role of ANS in the maintenance of systemic homeostasis, anesthesiologists and intensivists should recognize as critical the evaluation of ANS function. Measurement of heart rate variability (HRV) is an easily accessible window into autonomic activity. It is a low-cost, non-invasive and simple to perform method reflecting the balance of the ANS regulation of the heart rate and offers the opportunity to detect the presence of autonomic neuropathy complicating several illnesses. The present review provides anesthesiologists and intensivists with a comprehensive summary of the possible clinical implications of HRV measurements, suggesting that autonomic dysfunction testing could potentially represent a diagnostic and prognostic tool in the care of patients both in the perioperative setting as well as in the critical care arena.
    Acta Anaesthesiologica Scandinavica 07/2011; 55(7):797 - 811. · 2.19 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

30 patients
 
autonomic nerve tone
 
blood loss
 
Heart rate variability
 
HRV indices
 
HRV triangular index
 
indices correlated
 
low values
 
Mean heart rate
 
normal RR intervals
 
perioperative HRV
 
perioperative period
 
postoperative day 1
 
present results
 
significant relation
 
surgical stress
 
surgical stresses
 
surgical treatment
 
useful information
 
various stresses
 

Takafumi Ushiyama