Heart period variability in trauma patients may predict mortality and allow remote triage.
Heart period variability in trauma patients may predict mortality and allow remote triage.
复制标题
创伤患者的心率变异性可以预测死亡率并允许远程分类。
DOI：
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发表时间：
2006
影响因子：
--
通讯作者：
V. Convertino
中科院分区：
文献类型：
--
作者：
W. Cooke;J. Salinas;J. McManus;K. Ryan;C. Rickards;J. Holcomb;V. Convertino
介绍
高频低频比（HF/LF）来自心脏周期变异性的分析是升高的，并与严重受伤的患者在医院监测的死亡率。本研究的目的是测试心脏周期变异性测量的效用，作为指标的损伤严重程度的患者之前，明确的医疗干预。我们检验了存活与相对低HF/LF相关，死亡与相对高HF/LF相关的假设。
方法
我们对84例院前创伤患者的病历进行了回顾性分析（n=42名非幸存者; n=42名幸存者），这些患者是在直升机运送到1级城市创伤中心期间收集的。用傅立叶变换将ECG波形的2分钟段的R波转换到频域。将光谱功率分为低频（LF; 0.04-0.15 Hz）和高频（HF; 0.15-0.4 Hz）频带，用于分析和推导频率比。
结果
两组之间的绝对HF、LF和HF/LF在统计学上没有区别（p >或= 0.26），但非存活者的HF/LF（140 +/- 26）高于存活者（74 +/- 19）（p = 0.04）。考虑到受试者间较大的变异性进行标准化后，（43 +/- 3 vs. 28 +/- 2）和HF/LFnu（248 +/- 50 vs. 73 +/- 19）较高与存活者相比，非存活者[死亡前19小时（中位数）]的LFnu（42 +/- 4 vs. 64 +/- 3）较低（p = 0.0001）。
结论
我们的研究结果表明，心脏周期变异性分析将死亡的患者与创伤性损伤幸存的患者分开。我们建议，这样的分析可以用于在严峻的环境中受伤患者的远程分诊。
INTRODUCTION
The high frequency to low frequency ratio (HF/LF) derived from analysis of heart period variability is elevated and associated with mortality in severely injured patients monitored in a hospital. The purpose of this study was to test the utility of heart period variability measurements as indicators of injury severity in patients prior to definitive medical intervention. We tested the hypothesis that survival is associated with low relative HF/LF, and death is associated with high relative HF/LF.
METHODS
We performed retrospective analyses of 84 pre-hospital trauma patient records (n=42 non-survivors; n=42 survivors) collected during helicopter transport to a Level 1 urban trauma center. R-waves from 2-min segments of ECG waveforms were converted to the frequency domain with a Fourier transform. Spectral power was separated into low (LF; 0.04-0.15 Hz) and high (HF; 0.15-0.4 Hz) frequency bands for analysis and derivation of frequency ratios.
RESULTS
Absolute HF, LF, and HF/LF were not distinguishable statistically between groups (p > or = 0.26), but HF/LF was higher (p = 0.04) for non-survivors (140 +/- 26) than survivors (74 +/- 19). After normalization to account for large intersubject variability, HFnu (43 +/- 3 vs. 28 +/- 2) and HF/LFnu (248 +/- 50 vs. 73 +/- 19) were higher (both p < 0.001), and LFnu (42 +/- 4 vs. 64 +/- 3) was lower (p = 0.0001) for non-survivors [19 h (median) before death] compared with survivors.
CONCLUSIONS
Our results show that heart period variability analyses separate patients who die from patients who survive traumatic injury. We propose that such analyses could be employed for remote triage of injured patients in austere environments.
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影响因子：
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作者：
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通讯作者：
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DOI：
10.7182/prtr.10.1.96058260p25t75t5
发表时间：
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期刊：
Progress in transplantation (Aliso Viejo, Calif.)
影响因子：
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DOI：
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发表时间：
2005
期刊：
The Journal of trauma
影响因子：
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作者：
Grogan,EricL;Norris,PatrickR;Speroff,Theodore;Ozdas,Asli;France,DanielJ;Harris,PaulA;Jenkins,JudithM;Stiles,Renee;Dittus,RobertS;MorrisJr,JohnA
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作者：
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