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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
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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 |
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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 |
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