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Autonomic impairment of patients in coma with different Glasgow coma score assessed with heart rate variability.
Estévez-Báez, Mario; Machado, Calixto; García-Sánchez, Benjamín; Rodríguez, Valia; Alvarez-Santana, Reynaldo; Leisman, Gerry; Carrera, José Mario Estévez; Schiavi, Adam; Montes-Brown, Julio; Arrufat-Pié, Eduardo.
Afiliação
  • Estévez-Báez M; a Department of Clinical Neurophysiology , Institute of Neurology and Neurosurgery , Havana , Cuba.
  • Machado C; a Department of Clinical Neurophysiology , Institute of Neurology and Neurosurgery , Havana , Cuba.
  • García-Sánchez B; b Cuban Center of Neurosciences , Havana , Cuba.
  • Rodríguez V; b Cuban Center of Neurosciences , Havana , Cuba.
  • Alvarez-Santana R; c Department of Pathology , "Hermanos Ameijeiras" Hospital , Havana , Cuba.
  • Leisman G; d Faculty of Health Sciences , University of Haifa , Haifa , Israel.
  • Carrera JME; h Biomedical Engineering , Luis Diaz Soto Naval Hospital , Havana , Cuba.
  • Schiavi A; e Anesthesiology and Critical Care Medicine, Neurosciences Critical Care Division , Johns Hopkins Hospital , Baltimore , MD , USA.
  • Montes-Brown J; f Department of Medicine & Health Science , University of Sonora , Sonora , Mexico.
  • Arrufat-Pié E; g Institute of Basic and Preclinical Sciences, "Victoria de Girón" , Havana , Cuba.
Brain Inj ; 33(4): 496-516, 2019.
Article em En | MEDLINE | ID: mdl-30755043
PRIMARY OBJECTIVE: The objective of this study is to assess the functional state of the autonomic nervous system in healthy individuals and in individuals in coma using measures of heart rate variability (HRV) and to evaluate its efficiency in predicting mortality. DESIGN AND METHODS: Retrospective group comparison study of patients in coma classified into two subgroups, according to their Glasgow coma score, with a healthy control group. HRV indices were calculated from 7 min of artefact-free electrocardiograms using the Hilbert-Huang method in the spectral range 0.02-0.6 Hz. A special procedure was applied to avoid confounding factors. Stepwise multiple regression logistic analysis (SMLRA) and ROC analysis evaluated predictions. RESULTS: Progressive reduction of HRV was confirmed and was associated with deepening of coma and a mortality score model that included three spectral HRV indices of absolute power values of very low, low and very high frequency bands (0.4-0.6 Hz). The SMLRA model showed sensitivity of 95.65%, specificity of 95.83%, positive predictive value of 95.65%, and overall efficiency of 95.74%. CONCLUSIONS: HRV is a reliable method to assess the integrity of the neural control of the caudal brainstem centres on the hearts of patients in coma and to predict patient mortality.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Escala de Coma de Glasgow / Coma / Eletrocardiografia / Frequência Cardíaca Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Brain Inj Assunto da revista: CEREBRO Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Cuba País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Escala de Coma de Glasgow / Coma / Eletrocardiografia / Frequência Cardíaca Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Brain Inj Assunto da revista: CEREBRO Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Cuba País de publicação: Reino Unido