Cargando…

Depressed sympathovagal modulation indicates sepsis in patients with suspected infection

This study explored whether sympathovagal modulation assessed through frequency domains of heart rate variability (HRV) can indicate sepsis in patients with suspected infection. In total, 370 consecutive adult patients with suspected infection admitted to the emergency department were enrolled in th...

Descripción completa

Detalles Bibliográficos
Autores principales: Hsu, Ching-Tang, Tai, Henry Chih-Hung, Chung, Jui-Yuan, Chen, Jiann-Hwa, Chen, Wei-Lung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004643/
https://www.ncbi.nlm.nih.gov/pubmed/31977913
http://dx.doi.org/10.1097/MD.0000000000018961
_version_ 1783494769518837760
author Hsu, Ching-Tang
Tai, Henry Chih-Hung
Chung, Jui-Yuan
Chen, Jiann-Hwa
Chen, Wei-Lung
author_facet Hsu, Ching-Tang
Tai, Henry Chih-Hung
Chung, Jui-Yuan
Chen, Jiann-Hwa
Chen, Wei-Lung
author_sort Hsu, Ching-Tang
collection PubMed
description This study explored whether sympathovagal modulation assessed through frequency domains of heart rate variability (HRV) can indicate sepsis in patients with suspected infection. In total, 370 consecutive adult patients with suspected infection admitted to the emergency department were enrolled in this single-center cohort study. A continuous 10-minute electrocardiography for HRV analysis was recorded immediately for these patients after inclusion. Patients were stratified into non-sepsis and sepsis groups based on a sepsis-related organ failure assessment score of ≥2 that met the Third International Consensus Definitions for Sepsis. Seven frequency domains of HRV were compared between these 2 groups. Compared with the non-sepsis group (n = 98), the sepsis group (n = 272) had a significantly lower incidence of respiratory tract infection, higher total power, higher very-low-frequency component, higher high-frequency (HF) component, higher normalized HF component, lower normalized low-frequency (LF) component, and lower LF component/HF component ratio (LF/HF). Multiple logistic regression model identified HF component (odds ratio [OR] = 0.994; 95% confidence interval [CI], 0.990–0.999) and LF/HF (OR = 0.494; 95% CI, 0.423–0.578) as significant variables associated with sepsis. The area under receiver operating characteristic curves of HF component and LF/HF was 0.741 (95% CI, 0.685–0.797) and 0.930 (95% CI, 0.900–0.960), respectively, in identifying sepsis in patients with suspected infection. Tilted sympathovagal balance toward increased vagal activity and depressed sympathetic modulation, assessed by the HF component and LF/HF, may indicate sepsis in patients with suspected infection.
format Online
Article
Text
id pubmed-7004643
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-70046432020-02-18 Depressed sympathovagal modulation indicates sepsis in patients with suspected infection Hsu, Ching-Tang Tai, Henry Chih-Hung Chung, Jui-Yuan Chen, Jiann-Hwa Chen, Wei-Lung Medicine (Baltimore) 4100 This study explored whether sympathovagal modulation assessed through frequency domains of heart rate variability (HRV) can indicate sepsis in patients with suspected infection. In total, 370 consecutive adult patients with suspected infection admitted to the emergency department were enrolled in this single-center cohort study. A continuous 10-minute electrocardiography for HRV analysis was recorded immediately for these patients after inclusion. Patients were stratified into non-sepsis and sepsis groups based on a sepsis-related organ failure assessment score of ≥2 that met the Third International Consensus Definitions for Sepsis. Seven frequency domains of HRV were compared between these 2 groups. Compared with the non-sepsis group (n = 98), the sepsis group (n = 272) had a significantly lower incidence of respiratory tract infection, higher total power, higher very-low-frequency component, higher high-frequency (HF) component, higher normalized HF component, lower normalized low-frequency (LF) component, and lower LF component/HF component ratio (LF/HF). Multiple logistic regression model identified HF component (odds ratio [OR] = 0.994; 95% confidence interval [CI], 0.990–0.999) and LF/HF (OR = 0.494; 95% CI, 0.423–0.578) as significant variables associated with sepsis. The area under receiver operating characteristic curves of HF component and LF/HF was 0.741 (95% CI, 0.685–0.797) and 0.930 (95% CI, 0.900–0.960), respectively, in identifying sepsis in patients with suspected infection. Tilted sympathovagal balance toward increased vagal activity and depressed sympathetic modulation, assessed by the HF component and LF/HF, may indicate sepsis in patients with suspected infection. Wolters Kluwer Health 2020-01-24 /pmc/articles/PMC7004643/ /pubmed/31977913 http://dx.doi.org/10.1097/MD.0000000000018961 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 4100
Hsu, Ching-Tang
Tai, Henry Chih-Hung
Chung, Jui-Yuan
Chen, Jiann-Hwa
Chen, Wei-Lung
Depressed sympathovagal modulation indicates sepsis in patients with suspected infection
title Depressed sympathovagal modulation indicates sepsis in patients with suspected infection
title_full Depressed sympathovagal modulation indicates sepsis in patients with suspected infection
title_fullStr Depressed sympathovagal modulation indicates sepsis in patients with suspected infection
title_full_unstemmed Depressed sympathovagal modulation indicates sepsis in patients with suspected infection
title_short Depressed sympathovagal modulation indicates sepsis in patients with suspected infection
title_sort depressed sympathovagal modulation indicates sepsis in patients with suspected infection
topic 4100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004643/
https://www.ncbi.nlm.nih.gov/pubmed/31977913
http://dx.doi.org/10.1097/MD.0000000000018961
work_keys_str_mv AT hsuchingtang depressedsympathovagalmodulationindicatessepsisinpatientswithsuspectedinfection
AT taihenrychihhung depressedsympathovagalmodulationindicatessepsisinpatientswithsuspectedinfection
AT chungjuiyuan depressedsympathovagalmodulationindicatessepsisinpatientswithsuspectedinfection
AT chenjiannhwa depressedsympathovagalmodulationindicatessepsisinpatientswithsuspectedinfection
AT chenweilung depressedsympathovagalmodulationindicatessepsisinpatientswithsuspectedinfection