Anesthetists’ Heart Rate Variability as an Indicator of Performance During Induction of General Anesthesia and Simulated Critical Incidents
Anesthetists’ Heart Rate Variability as an Indicator of Performance During Induction of General Anesthesia and Simulated Critical Incidents
复制标题
麻醉师的心率变异性作为全身麻醉诱导和模拟危急事件期间的表现指标
DOI：
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发表时间：
2019
影响因子：
1.3
通讯作者：
C. Schulz
中科院分区：
文献类型：
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作者：
F. Schneider;Jan Martin;Matthias Skrzypczak;Dominik Hinzmann;D. Jordan;K. Wagner;C. Schulz
抽象的。在麻醉环境中，良好的表现描述了对患者没有威胁以及对挑战性和可能危及生命的情况的快速反应。在其他地方，性能和认知功能已与迷走神经介导的心率变异性（HRV）指标。本探索性研究探讨了麻醉师的心率变异性和他们的表现之间的相关性，在平静的诱导全身麻醉和在模拟的关键事件。在本研究中，从两组不同的麻醉师那里获得了心电图（ECG），这些麻醉师在手术室（OR，n = 38）中平安无事的真实的病例中以及在高保真人类患者模拟器环境中管理低血压情况期间提供全身麻醉（SIM，n = 23）。根据5分钟ECG记录计算频率、时域和非线性HRV指标。为了区分高性能（HP）和低性能（LP）个体，使用诱导所需的时间（在OR设置中）和低血压的长度和深度（在SIM设置中）作为性能相关因素。Mann-Whitney-U检验用于评估组内HRV的差异。在两种设置（OR和SIM）中，HP组和LP组之间的线性和非线性HRV指标无显著差异。此外，麻醉师的工作经验和性别与绩效无关。在提供全身麻醉和模拟危急事件期间，高绩效和低绩效个体在HRV指标、性别和工作经验方面没有差异。进一步的研究，包括在静息条件下的HRV是必要的。
Abstract. In the environment of anesthesia, good performance describes the absence of threat for the patient as well as a quick reaction to challenging and possibly life-threatening circumstances. Elsewhere, performance and cognitive function have been linked to indicators of vagally-mediated heart rate variability (HRV). This exploratory study examines the correlation between anesthetists’ HRV and their performance during uneventful induction of general anesthesia and during a simulated critical incident. For this study electrocardiograms (ECG) were obtained from two different groups of anesthetists providing general anesthesia in uneventful real cases in the operation room (OR, n = 38) and during the management of a hypotension scenario in a high-fidelity human patient simulator environment (SIM, n = 23). Frequency, time domain, and nonlinear HRV metrics were calculated from 5-min ECG recordings. To separate high performing (HP) and low performing (LP) individuals, the time needed for induction (in the OR setting) and the length and depth of hypotension (in the SIM setting) were used as performance correlates. The Mann-Whitney- U-test was used to assess differences in HRV within the groups. In both settings (OR and SIM), linear and nonlinear HRV metrics did not differ significantly between the HP and LP group. Also, the anesthetists’ work experience and sex were not related to performance. While providing general anesthesia and during a simulated critical incident, high and low performing individuals do not differ with respect to HRV metrics, sex, and work experience. Further research including the HRV under resting conditions is necessary.
影响因子：
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作者：
Arnsten, AFT;Goldman-Rakic, PS
通讯作者：
Goldman-Rakic, PS