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Respiratory Rate Variability as a Prognostic Factor in Hospitalized Patients Transferred to the Intensive Care Unit

Introduction Increasing mortality rates within the intensive care unit (ICU) is an ever growing problem, ultimately leading to increases in the cost of healthcare expenditures. Currently, there are attempts to use guidelines in the hospital setting to predict overall mortality in critically ill pati...

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Autores principales: Garrido, Daniel, Assioun, Justin J, Keshishyan, Anahit, Sanchez-Gonzalez, Marcos A, Goubran, Bishoy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866112/
https://www.ncbi.nlm.nih.gov/pubmed/29581913
http://dx.doi.org/10.7759/cureus.2100
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author Garrido, Daniel
Assioun, Justin J
Keshishyan, Anahit
Sanchez-Gonzalez, Marcos A
Goubran, Bishoy
author_facet Garrido, Daniel
Assioun, Justin J
Keshishyan, Anahit
Sanchez-Gonzalez, Marcos A
Goubran, Bishoy
author_sort Garrido, Daniel
collection PubMed
description Introduction Increasing mortality rates within the intensive care unit (ICU) is an ever growing problem, ultimately leading to increases in the cost of healthcare expenditures. Currently, there are attempts to use guidelines in the hospital setting to predict overall mortality in critically ill patients. However, a predictor of subsequent ICU admissions remains to be explored. Recent data has shown the importance of monitoring respiratory rate variability (RRV) as a useful predictor of the deterioration of patients. Respiratory rate, in comparison to blood pressure or pulse rate, is deemed as the better determinant in identifying high-risk patients. Aim Our study aims to assess the role of RRV monitoring as a potential prognostic marker predictive of ICU admission. Results There was a significant (p = 0.009) increase in RRV between the third and fourth set of respiratory rates prior to ICU admission, such that coefficient of variation percentage (CV%) increased from 0.3% (95% confidence interval (CI): 0.09 - 0.42) to 0.7% (95% CI: 0.04 - 0.9) about 12 hours before admission to the ICU independent from diagnosis. Conclusion Using elevated RRV as a signal may be a useful prognostic tool in providing early intervention, thus reducing the incidence of subsequent morbidity and mortality in patients that might necessitate an ICU admission.
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spelling pubmed-58661122018-03-26 Respiratory Rate Variability as a Prognostic Factor in Hospitalized Patients Transferred to the Intensive Care Unit Garrido, Daniel Assioun, Justin J Keshishyan, Anahit Sanchez-Gonzalez, Marcos A Goubran, Bishoy Cureus Internal Medicine Introduction Increasing mortality rates within the intensive care unit (ICU) is an ever growing problem, ultimately leading to increases in the cost of healthcare expenditures. Currently, there are attempts to use guidelines in the hospital setting to predict overall mortality in critically ill patients. However, a predictor of subsequent ICU admissions remains to be explored. Recent data has shown the importance of monitoring respiratory rate variability (RRV) as a useful predictor of the deterioration of patients. Respiratory rate, in comparison to blood pressure or pulse rate, is deemed as the better determinant in identifying high-risk patients. Aim Our study aims to assess the role of RRV monitoring as a potential prognostic marker predictive of ICU admission. Results There was a significant (p = 0.009) increase in RRV between the third and fourth set of respiratory rates prior to ICU admission, such that coefficient of variation percentage (CV%) increased from 0.3% (95% confidence interval (CI): 0.09 - 0.42) to 0.7% (95% CI: 0.04 - 0.9) about 12 hours before admission to the ICU independent from diagnosis. Conclusion Using elevated RRV as a signal may be a useful prognostic tool in providing early intervention, thus reducing the incidence of subsequent morbidity and mortality in patients that might necessitate an ICU admission. Cureus 2018-01-23 /pmc/articles/PMC5866112/ /pubmed/29581913 http://dx.doi.org/10.7759/cureus.2100 Text en Copyright © 2018, Garrido et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Garrido, Daniel
Assioun, Justin J
Keshishyan, Anahit
Sanchez-Gonzalez, Marcos A
Goubran, Bishoy
Respiratory Rate Variability as a Prognostic Factor in Hospitalized Patients Transferred to the Intensive Care Unit
title Respiratory Rate Variability as a Prognostic Factor in Hospitalized Patients Transferred to the Intensive Care Unit
title_full Respiratory Rate Variability as a Prognostic Factor in Hospitalized Patients Transferred to the Intensive Care Unit
title_fullStr Respiratory Rate Variability as a Prognostic Factor in Hospitalized Patients Transferred to the Intensive Care Unit
title_full_unstemmed Respiratory Rate Variability as a Prognostic Factor in Hospitalized Patients Transferred to the Intensive Care Unit
title_short Respiratory Rate Variability as a Prognostic Factor in Hospitalized Patients Transferred to the Intensive Care Unit
title_sort respiratory rate variability as a prognostic factor in hospitalized patients transferred to the intensive care unit
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866112/
https://www.ncbi.nlm.nih.gov/pubmed/29581913
http://dx.doi.org/10.7759/cureus.2100
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