PMID- 11426105
OWN - NLM
STAT- MEDLINE
DCOM- 20010823
LR  - 20220330
IS  - 0898-4921 (Print)
IS  - 0898-4921 (Linking)
VI  - 13
IP  - 3
DP  - 2001 Jul
TI  - Could heart rate variability predict outcome in patients with severe head injury? 
      A pilot study.
PG  - 260-8
AB  - Despite major improvements in the resuscitation of patients with head injury, the 
      outcome of patients with head trauma often remains poor and difficult to 
      establish. Heart rate variability (HRV) analysis is a noninvasive tool used to 
      measure autonomic nervous system (ANS) activity. The aim of this prospective 
      study was to investigate whether HRV analysis might be a useful adjunct for 
      predicting outcome in patients with severe head injury. Twenty patients with 
      severe head trauma (Glasgow Coma Scale [GCS] <or= 8) underwent 24-hour 
      electrocardiogram recording 1 day after trauma and again 48 hours after 
      withdrawal of sedative drugs. Heart rate variability was assessed, in both time 
      domain and spectral domain. The authors initially compared (on Day 1) HRV in 
      patients who progressed to brain death to HRV in survivors; then during the 
      awakening period compared HRV in surviving patients with good recovery (GCS >or= 
      10) to HRV in patients characterized by a worsened neurologic state (GCS < 10). 
      Statistical analysis used the Kruskal-Wallis test, P < .05. To assess whether HRV 
      could predict evolution to brain death, receiver operating characteristic (ROC) 
      curves were generated the day after trauma for Total Power, natural logarithm of 
      high-frequency component of spectral analysis (LnHF), natural logarithm of 
      low-frequency component of spectral analysis (LnLF), and root mean square for 
      successive interval differences (rMSSD). Seven patients died between Day 1 and 
      Day 5 after trauma. Six of those had progressed to brain death. In these six 
      patients, at Day 1, Global HRV and parasympathetic tone were significantly 
      higher. Referring to the area under the rMSSD ROC curve, HRV might provide useful 
      information in predicting early evolution of patients with severe head trauma. 
      During the awakening period, global HRV and the parasympathetic tone were 
      significantly lower in the worsened neurologic state group. In conclusion, HRV 
      could be helpful as a predictor of imminent brain death and a useful adjunct for 
      predicting the outcome of patients with severe head injury.
FAU - Rapenne, T
AU  - Rapenne T
AD  - Departement d' Anesthesie-Reanimation, Hopital General, Dijon, Cedex, France.
FAU - Moreau, D
AU  - Moreau D
FAU - Lenfant, F
AU  - Lenfant F
FAU - Vernet, M
AU  - Vernet M
FAU - Boggio, V
AU  - Boggio V
FAU - Cottin, Y
AU  - Cottin Y
FAU - Freysz, M
AU  - Freysz M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Neurosurg Anesthesiol
JT  - Journal of neurosurgical anesthesiology
JID - 8910749
SB  - IM
CIN - J Neurosurg Anesthesiol. 2004 Jan;16(1):62. PMID: 14676571
MH  - Accidental Falls
MH  - Accidents, Traffic
MH  - Arrhythmias, Cardiac
MH  - Blood Pressure/*physiology
MH  - Body Temperature Regulation
MH  - Brain Death
MH  - Brain Injuries/mortality/*physiopathology/therapy
MH  - Craniocerebral Trauma/mortality/*physiopathology/therapy
MH  - Disease Progression
MH  - Female
MH  - Glasgow Coma Scale
MH  - Heart Rate/*physiology
MH  - Humans
MH  - Male
MH  - Monitoring, Physiologic
MH  - Patient Selection
MH  - Pilot Projects
MH  - Predictive Value of Tests
MH  - ROC Curve
MH  - Resuscitation
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2001/06/27 10:00
MHDA- 2001/08/24 10:01
CRDT- 2001/06/27 10:00
PHST- 2001/06/27 10:00 [pubmed]
PHST- 2001/08/24 10:01 [medline]
PHST- 2001/06/27 10:00 [entrez]
AID - 10.1097/00008506-200107000-00016 [doi]
PST - ppublish
SO  - J Neurosurg Anesthesiol. 2001 Jul;13(3):260-8. doi: 
      10.1097/00008506-200107000-00016.