• Neurocritical care · Aug 2016

    Heart Rate Variability Predicts Neurogenic Pulmonary Edema in Patients with Subarachnoid Hemorrhage.

    • Wei-Lung Chen, Su-Hen Chang, Jiann-Hwa Chen, Henry Chih-Hung Tai, Chia-Meng Chan, and Yung-Cheng Wang.
    • Department of Emergency Medicine, Cathay General Hospital, No. 280, Sec. 4, Jen-Ai Road, Taipei, 106, Taiwan. weilung.chen@msa.hinet.net.
    • Neurocrit Care. 2016 Aug 1; 25 (1): 71-8.

    BackgroundAn alternation of sympathetic and vagal nervous activity has been suggested to be one possible mechanism of neurogenic pulmonary edema (NPE) in patients with subarachnoid hemorrhage (SAH). The study aimed to explore if sympathovagal modulation assessed by frequency domains of heart rate variability (HRV) is associated with impending NPE in patients with SAH.MethodsTwo hundred forty-eight consecutive spontaneous SAH adult patients were included in this single-center cohort study. A continuous 10-min electrocardiography for HRV analysis was recorded. The patients were stratified into NPE and non-NPE based on serially clinical and radiologic findings within 24 h. Seven frequency domains of HRV were compared between these 2 groups.ResultsCompared to the non-NPE (n = 212), the NPE (n = 36) had significantly higher mean arterial pressure, higher World Federation of Neurological Surgeons (WFNS) class, higher Hunt-Hess scale, lower total power (TP), lower very low-frequency component, lower low-frequency component, lower normalized low-frequency component (LF %), higher normalized high-frequency component, and lower low-frequency component/high-frequency component ratio. Multiple logistic regression model identified WFNS class (OR 4.048; 95 % CI 1.589-10.311), LF % (OR 0.933; 95 % CI 0.910-0.958), and TP (OR 0.995; 95 % CI 0.992-0.998) as the significant variables associated with occurrence of NPE. The area under receiver operating characteristic curves of LF % and TP were found to be 0.838 (95 % CI 0.774-0.901) and 0.653 (95 % CI 0.557-0.749), respectively.ConclusionLoss of cardiac variability and depressed sympathovagal modulation, represented by TP and LF %, may predict the development of NPE in the early stage in patients with SAH.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…