Feasibility of continuous multiorgan variability analysis in the intensive care unit.
Abstract: Purpose: The aim of the study was to evaluate the feasibility of continuous heart and respiratory rate variability (HRV and RRV, respectively) monitoring in critically ill patients derived from electrocardiogram (ECG) and end-tidal capnography (etCO2) waveforms. Methods: Thirty-four patien...
| Publicado en: | Journal of Critical Care Vol. 27; no. 2; pp. 218.e9 - 218000000001 |
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| Autores principales: | , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Apr2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104540593&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104540593 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08839441 1YR jtl: Journal of Critical Care issn: 08839441 maglogo: N pubinfo: dt: Apr2012 vid: 27 iid: 2 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 104540593 73800778 10.1016/j.jcrc.2011.09.009 NLM22172799 104540593 ppf: 218.e9 ppct: 1 formats: tig: atl: Feasibility of continuous multiorgan variability analysis in the intensive care unit. aug: au: Bradley, Beverly Green, Geoffrey C. Batkin, Izmail Seely, Andrew J.E. affil: Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, K1H 8L6 sug: subj: Intensive Care Units Patient Assessment Multiple Organ Dysfunction Syndrome Diagnosis Critical Care Critically Ill Patients Heart Rate Evaluation Capnography Tidal Volume Evaluation Human Electrocardiography Descriptive Statistics Carbon Dioxide Analysis ab: Abstract: Purpose: The aim of the study was to evaluate the feasibility of continuous heart and respiratory rate variability (HRV and RRV, respectively) monitoring in critically ill patients derived from electrocardiogram (ECG) and end-tidal capnography (etCO2) waveforms. Methods: Thirty-four patients (age, 56.5 ± 15.9 years; Acute Physiology and Chronic Health Evaluation II score, 22.8 ± 6.7) underwent continuous recording of ECG and etCO2 waveforms from intensive care unit admission and intubation to discharge or maximum of 14 days. Overlapping 5-minute windows were analyzed with a wide range of variability measures (time, frequency, entropy, and scale-invariant and nonlinear domains). Waveform data quality, presence of disconnections and arrhythmias, quality of beat and breath detection, and subsequent variability computations were evaluated. Results: Patients were enrolled for 11.0 ± 3.6 days. The proportion of missing waveform data among all patients was (median [interquartile range, maximum]) 2.9% (1.3%-9.7%, 36.4%) for ECG and 3.1% (1.1%-11.4%, 84.5%) for etCO2. Heart rate variability data loss (ie, proportion of windows removed) was 1.3% (1.0%-2.1%, 5.9%) due to disconnection, 0.6% (0.1%-3.9%, 39.5%) due to atrial fibrillation, and 6.6% (1.4%-17.9%, 89.0%) due to data cleaning. Respiratory rate variability data loss was 7.3% (2.9%-11.6%, 47.7%) due to disconnection (or apnea) and 5.5% (2.9%-8.4%, 56.4%) due to cleaning. Continuous individualized multiorgan variability analysis processing resulted in HRV and RRV computations for 81.2% ± 25.0% and 87.5% ± 11.9% of available ECG and etCO2 waveform data, respectively. Conclusions: The quality of continuously recorded ECG and etCO2 waveforms in critically ill patients is adequate for subsequent continuous variability monitoring in this pilot study. The clinical utility of continuous variability analysis merits further investigation. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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