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Heart rate variability as predictor of mortality in sepsis: A prospective cohort study

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  • Fábio M de Castilho
  • Antonio Luiz P Ribeiro
  • José Luiz P da Silva
  • Vandack Nobre
  • Marcos R de Sousa

Abstract

Background: Sepsis is a serious medical condition with increasing prevalence and high mortality. The role of the autonomic nervous system in pathophysiology of sepsis has been increasingly researched. The objective of this study is to evaluate the Heart rate variability (HRV) as a predictor of mortality in septic patients. Methods: This was a prospective cohort of patients diagnosed with sepsis. Patient recruitment was carried out at ICU in tertiary university hospital between March 2012 and February 2014. Clinical data and laboratory exams were collected at admission. Each patient underwent a 20-minute Holter and a 24-hour Holter on the first day of enrollment. The primary outcome was the 28-day all-cause mortality. Results: A total of 63 patients were included. Patients were categorized into nonsurvivor group (n = 16) or survivor group (n = 47) depending on this endpoint. Survivors were younger (48.6 years vs. 63.0 years), had better renal function and lower values in severity scores (APACHE II and SOFA) compared to nonsurvivors. In the 20-minute Holter, SDNN, Total Power, VLF Power, LF Power and LF/HF of nonsurvivors were significantly lower than those of survivors (p =

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  • Fábio M de Castilho & Antonio Luiz P Ribeiro & José Luiz P da Silva & Vandack Nobre & Marcos R de Sousa, 2017. "Heart rate variability as predictor of mortality in sepsis: A prospective cohort study," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-15, June.
    • Handle: RePEc:plo:pone00:0180060
    DOI: 10.1371/journal.pone.0180060
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    1. Lyudmila V. Borovikova & Svetlana Ivanova & Minghuang Zhang & Huan Yang & Galina I. Botchkina & Linda R. Watkins & Haichao Wang & Naji Abumrad & John W. Eaton & Kevin J. Tracey, 2000. "Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin," Nature, Nature, vol. 405(6785), pages 458-462, May.
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    1. Fábio M de Castilho & Antonio Luiz P Ribeiro & Vandack Nobre & Guilherme Barros & Marcos R de Sousa, 2018. "Heart rate variability as predictor of mortality in sepsis: A systematic review," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-13, September.
    2. Yuzhe Liu & Jody Manners & Yazan Bittar & Sherry H-Y Chou & Vanathi Gopalakrishnan, 2019. "Towards precision critical care management of blood pressure in hemorrhagic stroke patients using dynamic linear models," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-28, August.
    3. Jeremy Zhenwen Pong & Stephanie Fook-Chong & Zhi Xiong Koh & Mas’uud Ibnu Samsudin & Takashi Tagami & Calvin J. Chiew & Ting Hway Wong & Andrew Fu Wah Ho & Marcus Eng Hock Ong & Nan Liu, 2019. "Combining Heart Rate Variability with Disease Severity Score Variables for Mortality Risk Stratification in Septic Patients Presenting at the Emergency Department," IJERPH, MDPI, vol. 16(10), pages 1-14, May.
    4. Sumanth Madhusudan Prabhakar & Takashi Tagami & Nan Liu & Mas’uud Ibnu Samsudin & Janson Cheng Ji Ng & Zhi Xiong Koh & Marcus Eng Hock Ong, 2019. "Combining quick sequential organ failure assessment score with heart rate variability may improve predictive ability for mortality in septic patients at the emergency department," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-11, March.

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