Heart Rate Variability as an Indicator of Autonomic Nervous System Disturbance in Tetanus
Heart Rate Variability as an Indicator of Autonomic Nervous System Disturbance in Tetanus
复制标题
DOI：
10.4269/ajtmh.19-0720
复制
发表时间：
2020-02-01
影响因子：
3.3
通讯作者：
Thwaites, Louise
中科院分区：
文献类型：
--
作者：
Ha Thi Hai Duong;Tadesse, Girmaw Abebe;Thwaites, Louise
自主神经系统功能障碍（ANSD）是破伤风死亡的重要原因。目前，诊断依赖于非特异性临床体征。心率变异性（HRV）可能表明潜在的自主神经系统活动，并代表了一个潜在的有价值的非侵入性工具，ANSD诊断破伤风。心率变异性是通过24小时内三次5分钟的心电图记录来测量的，这些患者都接受了机械通气。所有受试者的HRV测量结果显示，5名ANSD患者（Ablett 4级）和4名无ANSD患者（Ablett 3级）的HRV低于健康个体的报告范围。比较不同程度破伤风患者，ANSD患者HRV的时间和频率测量原始数据均较无ANSD者减少。除均方根标准差外，其他指标的差异均有统计学意义，提示HRV可能是诊断ANSD的一个有价值的工具。
Autonomic nervous system dysfunction (ANSD) is a significant cause of mortality in tetanus. Currently, diagnosis relies on nonspecific clinical signs. Heart rate variability (HRV) may indicate underlying autonomic nervous system activity and represents a potentially valuable noninvasive tool for ANSD diagnosis in tetanus. HRV was measured from three 5-minute electrocardiogram recordings during a 24-hour period in a cohort of patients with severe tetanus, all receiving mechanical ventilation. HRV measurements from all subjects-five with ANSD (Ablett Grade 4) and four patients without ANSD (Ablett Grade 3)-showed HRV was lower than reported ranges for healthy individuals. Comparing different severities of tetanus, raw data for both time and frequency measurements of HRV were reduced in those with ANSD compared with those without. Differences were statistically significant in all except root mean square SD, indicating HRV may be a valuable tool in ANSD diagnosis.