Clinical review: a review and analysis of heart rate variability and the diagnosis and prognosis of infection.
Clinical review: a review and analysis of heart rate variability and the diagnosis and prognosis of infection.
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DOI：
10.1186/cc8132
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Seely AJ
中科院分区：
文献类型：
--
作者：
Ahmad S;Tejuja A;Newman KD;Zarychanski R;Seely AJ
细菌感染导致器官衰竭是危重患者最常见的死亡原因。早期诊断和迅速治疗是治疗的基石。评价全身宿主对感染的反应作为一个复杂的系统提供了新的见解：然而，临床价值的床边应用仍然需要。提供改变的宿主反应的综合测量，可以用一组数学技术来分析在时间间隔上测量的心率波动的模式和特征，所述数学技术量化总体波动、频谱组成、无标度变化和不规则性或复杂性的程度。使用这些技术，心率变异性（HRV）已被证明在全身感染的情况下会发生变化，并与其严重程度相关。在这篇综述和分析中，我们评估了使用HRV监测来提供感染的早期诊断，记录了感染中HRV改变的预后影响，确定了当前的局限性，强调了未来的研究挑战，并提出了改进策略。考虑到现有的证据和进一步技术进步的潜力，我们认为，在有感染风险或存在感染的危重患者中进行纵向、个体化和全面的HRV监测提供了一种利用复杂系统科学床边应用的临床潜力的方法。
Bacterial infection leading to organ failure is the most common cause of death in critically ill patients. Early diagnosis and expeditious treatment is a cornerstone of therapy. Evaluating the systemic host response to infection as a complex system provides novel insights: however, bedside application with clinical value remains wanting. Providing an integrative measure of an altered host response, the patterns and character of heart rate fluctuations measured over intervals-in-time may be analysed with a panel of mathematical techniques that quantify overall fluctuation, spectral composition, scale-free variation, and degree of irregularity or complexity. Using these techniques, heart rate variability (HRV) has been documented to be both altered in the presence of systemic infection, and correlated with its severity. In this review and analysis, we evaluate the use of HRV monitoring to provide early diagnosis of infection, document the prognostic implications of altered HRV in infection, identify current limitations, highlight future research challenges, and propose improvement strategies. Given existing evidence and potential for further technological advances, we believe that longitudinal, individualized, and comprehensive HRV monitoring in critically ill patients at risk for or with existing infection offers a means to harness the clinical potential of this bedside application of complex systems science.
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影响因子：
3.6
作者：
Griffin, MP;O'Shea, TM;Moorman, JR
通讯作者：
Moorman, JR
影响因子：
3.6
作者：
Griffin, MP;O'Shea, TM;Moorman, JR
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8
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8
作者：
Griffin, MP;Lake, DE;Moorman, JR
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Moorman, JR
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作者：
Griffin, MP;Moorman, JR
通讯作者：
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