Experimental human endotoxemia increases cardiac regularity: Results from a prospective, randomized, crossover trial
Experimental human endotoxemia increases cardiac regularity: Results from a prospective, randomized, crossover trial
复制标题
DOI：
10.1097/00003246-199607000-00009
复制
发表时间：
1996-07-01
影响因子：
8.8
通讯作者：
Suffredini, AF
中科院分区：
文献类型：
--
作者：
Godin, PJ;Fleisher, LA;Suffredini, AF
目的：确定人类内毒素血症是否与心率的生理心跳变异性丧失相关，设计：前瞻性、随机、交叉、单盲研究，环境：联邦非大学医院临床研究中心，受试者：健康志愿者，干预措施，静脉注射参比（大肠杆菌）内毒素或生理盐水安慰剂，既往是否口服布洛芬，测量和主要结果：心电图连续记录并数字化，使用一系列超过8小时的1000次R-R间隔，分析包括时域（标准差），频域（功率谱）和规律性测量（近似熵），内毒素给药与变异性的损失有关，即使使用布洛芬，变异性的损失仍然显著。阻断了发烧和内毒素相关症状的发展结论:将内毒素注入人体志愿者体内会导致心率变异性的丧失（通过标准偏差和功率谱测量），以及心率规律性的增加（通过近似熵测量）。近似熵的变化比其他心率变异性测量的变化发生得更早，可能是检测早期败血症的有用手段。这种规律性的减少与多器官系统功能障碍综合征的发病机制涉及重要器官系统的生理解偶联的模型一致。
Objective: To determine whether human endotoxemia is associated with a loss of the physiologic beat-to beat variability of heart rate,Design: Prospective, randomized, crossover, single blind study, Setting: Clinical research center in a federal, nonuniversity hospital,Subjects: Healthy volunteers,Interventions,, Intravenous administration of reference (Escherichia coli) endotoxin or saline placebo, with or without previous administration of oral ibuprofen,Measurements and Main Results: Electrocardiograms were continuously recorded and digitized using series of 1000 beat epochs of R-R intervals over 8 hrs, Analyses included measures in the time domain (standard deviation), frequency domain (power spectra), and a measure of regularity (approximate entropy), Endotoxin administration was associated with loss of variability by all measures, This loss of variability remained significant even with administration of ibuprofen, which blocked the development of fever and endotoxin related symptoms. Conclusions: 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 measured by approximate entropy, Changes in ap proximate entropy occurred earlier than changes in other heart rate variability measures and may be a useful means of detecting early sepsis, This reduction in regularity is consistent with a model in which the pathogenesis of multiple organ system dysfunction syndrome involves the physiologic uncoupling of vital organ systems.