Online ISSN: 2515-8260

Keywords : Critical ill patients


Heart Rate Variability As A Prognostic Marker In Critical Ill Patients

Yogesh Kautikrao Kakde; Shilpa Gaidhane; Sourya Acharya; Sunil Kumar; Amrutha .

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 3872-3879

Background:Heart rate variability is defined as fluctuation in the time interval between adjacent heart beats. For the maintenance of structural processes, the autonomic nervous system (ANS) is important. Loss of normal autonomic function may occur due to inflammation and/or injury during critical illness. Organ dysfunction, increased illness severity, and poor result have resulted in disturbance in systemic homeostasis caused by ANS abnormality in regulation.
Objectives:
● To determine 24 hours Heart rate variability among patients admitted to critical care unit on admission and one day prior to discharge.
● To determine role of heart rate variability and other risk factors as a prognostic marker for 90 day survival among patients admitted to critical care unit.
● Mortality and Duration of MICU stay.
Methods:The patients who are admitted in Medicine critical care unit will be selected for the study and they will be evaluated for HRV and APACHE IV scoring. APACHE IV is prognostic test used to classify the severity of critical illness. (Attached in proforma) Patients demographic profile, Waist Circumference, Addiction history, history of other comorbid diseases like HTN,DM, CAD ,MI ,STROKE, SEPSIS will be documented from the patients case file. Patients outcome like mortality duration of hospital stay and 90 day survival will be obtained .The follow up at 90 th day will be done by telephonic consultation. Heart rate variability patient will be attached to HRV monitor for 24 hours and following values will be studied.Expected Results:The study will analyse HRV readings calculation from the starting and ending of whole day and night of MICU stay. Mixed effects models will demonstrate that result of three measurement of HRV will be relatively lower from the starting of day and night compared to the last day and night of MICU admission. Exploration of the relationship between the variability of time from enrollment and log heart rate values, over the last day and night of MICU stay, the expected average HRV will persist significantly higher in comparison with the first day and night.