The Use of Power Spectral Analysis of Heart Rate Variability in Assessing Sedation Level of Critically Ill Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/153593
Type:
Presentation
Title:
The Use of Power Spectral Analysis of Heart Rate Variability in Assessing Sedation Level of Critically Ill Patients
Abstract:
The Use of Power Spectral Analysis of Heart Rate Variability in Assessing Sedation Level of Critically Ill Patients
Conference Sponsor:Sigma Theta Tau International
Conference Year:2005
Author:Huang, Yi-Feng, RN
P.I. Institution Name:Taipei Veterans General Hospital
Title:The Use of Power Spectral Analysis of Heart Rate Variability in Assessing Sedation Level of Critically Ill Patients
Co-Authors:Huey-Wen Yien, MD, PhD; Yann-Fen C. Chao, RN, DNSc
Anxiety and agitation of patient are common in the intensive care unit (ICU), thus sedation is required. The intensivists need a reliable tool as a guide to assess the sedation level. The aim of this study is to compare the power spectral analysis of heart rate variability (HRV) with the bispectral index (BIS), the subjective Sedation-Agitation Scale (SAS) and Ramsay Sedation Score (RSS) in assessing sedation level of the critically-ill patients. The changes of respiratory status and hemodynamic parameters of patients before and after continually sedated were also evaluated. 25 surgical ICU patients were enrolled in this study. Patients were divided into two groups under continuous sedation with propofol (1.5 mg/kg/hr) or midazolam (0.1 mg/kg/hr) for 24 hours. An hour of electrocardiogram(EKG) was recorded for heart rate signal analysis before sedation,12th and 24th hour after continuous sedation. The SAS, RSS scores and BIS index were measured simultaneously during EKG recording. The Acute Physiology And Chronic Health Evaluation (APACHE) II score and other routine parameters were also recorded. Under short-term sedation in the ICU, patients in midazolam group represented a deeper sedation level than propofol by both subjective scores and BIS index without significant change in the standard deviation of successive R-R intervals (SDNN) and very low frequency (VLF, 0.004~0.04Hz) power density after 24-hours continuous sedation. However, there were lower SDNN and VLF power density which correlated with the adverse effect of hypotension in the propofol group after 24-hours continuous sedation.. It's difficult to detect subtle decompensations of critically ill patients under continuous sedation. Objective tools provide additional messages for clinical intensivists, even the respiratory and hemodynamic status of the patients were well-maintained. Combination of HRV, BIS and subjective scores may be beneficial for comprehensive monitoring of the sedation level to avoid oversedation and suppression of autonomic modulation in critically-ill patients.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Use of Power Spectral Analysis of Heart Rate Variability in Assessing Sedation Level of Critically Ill Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/153593-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Use of Power Spectral Analysis of Heart Rate Variability in Assessing Sedation Level of Critically Ill Patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Huang, Yi-Feng, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Taipei Veterans General Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">The Use of Power Spectral Analysis of Heart Rate Variability in Assessing Sedation Level of Critically Ill Patients</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">yfhwang@vghtpe.gov.tw</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Huey-Wen Yien, MD, PhD; Yann-Fen C. Chao, RN, DNSc</td></tr><tr><td colspan="2" class="item-abstract">Anxiety and agitation of patient are common in the intensive care unit (ICU), thus sedation is required. The intensivists need a reliable tool as a guide to assess the sedation level. The aim of this study is to compare the power spectral analysis of heart rate variability (HRV) with the bispectral index (BIS), the subjective Sedation-Agitation Scale (SAS) and Ramsay Sedation Score (RSS) in assessing sedation level of the critically-ill patients. The changes of respiratory status and hemodynamic parameters of patients before and after continually sedated were also evaluated. 25 surgical ICU patients were enrolled in this study. Patients were divided into two groups under continuous sedation with propofol (1.5 mg/kg/hr) or midazolam (0.1 mg/kg/hr) for 24 hours. An hour of electrocardiogram(EKG) was recorded for heart rate signal analysis before sedation,12th and 24th hour after continuous sedation. The SAS, RSS scores and BIS index were measured simultaneously during EKG recording. The Acute Physiology And Chronic Health Evaluation (APACHE) II score and other routine parameters were also recorded. Under short-term sedation in the ICU, patients in midazolam group represented a deeper sedation level than propofol by both subjective scores and BIS index without significant change in the standard deviation of successive R-R intervals (SDNN) and very low frequency (VLF, 0.004~0.04Hz) power density after 24-hours continuous sedation. However, there were lower SDNN and VLF power density which correlated with the adverse effect of hypotension in the propofol group after 24-hours continuous sedation.. It's difficult to detect subtle decompensations of critically ill patients under continuous sedation. Objective tools provide additional messages for clinical intensivists, even the respiratory and hemodynamic status of the patients were well-maintained. Combination of HRV, BIS and subjective scores may be beneficial for comprehensive monitoring of the sedation level to avoid oversedation and suppression of autonomic modulation in critically-ill patients.</td></tr></table>en_GB
dc.date.available2011-10-26T12:22:43Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T12:22:43Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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