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Erschienen in: Wiener klinische Wochenschrift 7-8/2017

01.04.2017 | original article

Respiratory induced heart rate variability during slow mechanical ventilation

Marker to exclude brain death patients

verfasst von: Pavel Jurak, Josef Halamek, Vlastimil Vondra, Dr. Peter Kruzliak, Vladimir Sramek, Ivan Cundrle, Pavel Leinveber, Mariusz Adamek, Dr. Vaclav Zvonicek

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 7-8/2017

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Summary

Background

Respiratory induced heart rate variability (rHRV) was analysed in mechanically ventilated patients during two levels of sedation and brain death. Our aim was to determine whether rHRV can distinguish between different levels of sedation and especially between brain death and sedated patients.

Methods

In this study 30 critically ill and 23 brain death patients were included and four respiratory rates of 15, 12, 8 and 6 breaths per minute, each lasting 5 min were used. Two sedation levels, basal and deep, were performed in the critically ill patients. Heart rate and blood pressure changes induced by ventilation were subsequently detected and analysed.

Results

Significant differences were found in rHRV and rHRV adjusted for tidal volume (rHRV/VT) between critically ill and brain death patients during slow breathing at 6 or 8 breaths per minute. The rHRV at 6 breaths per minute was below 15 ms in all brain death subjects except one. The rHRV/VT was lower than 25 ms/l at both 6 and 8 breaths per minute in all brain death patients and simultaneously at 75% of non-brain death patients was higher (specificity 1, sensitivity 0.24). Differences in rHRV and rHRV/VTs between basal and deep sedation were not significant.

Conclusions

The main clinical benefit of the study is the finding that rHRV and rHRV/VT during 6 and 8 breaths per minute can differentiate between critically ill and brain death patients. An rHRV/VT exceeding 25 ms/l reliably excludes brain death.
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Metadaten
Titel
Respiratory induced heart rate variability during slow mechanical ventilation
Marker to exclude brain death patients
verfasst von
Pavel Jurak
Josef Halamek
Vlastimil Vondra
Dr. Peter Kruzliak
Vladimir Sramek
Ivan Cundrle
Pavel Leinveber
Mariusz Adamek
Dr. Vaclav Zvonicek
Publikationsdatum
01.04.2017
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 7-8/2017
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-017-1176-0