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Novel method to quantify loss of heart rate variability in pediatric multiple organ failure.

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Title: Novel method to quantify loss of heart rate variability in pediatric multiple organ failure.
Authors: Shane M. Tibby, Helena Frndova, Andrew Durward, Peter N. Cox
Source: Critical Care Medicine. Jul2003, Vol. 31 Issue 7, p2059-2067. 9p.
Subject Terms: *HEART beat, *MULTIPLE organ failure, *PEDIATRICS, *HEMODYNAMICS
Abstract: OBJECTIVE To develop a power-law model for measurement of heart rate variability (HRV) and to compare this model with established methods for measuring HRV in a group of children with organ failure (OF).DESIGN Prospective, observational study.SETTING Pediatric intensive care unit of a tertiary children''s hospital.PATIENTS A total of 104 measurements were made on 50 patients (median age, 8 months; range, 2 days to 16 yrs) and categorized into three groups according to the number of simultaneous organs failing: 0-1 OF, 2 OF, and ≥3 OF.INTERVENTIONS Heart rate was recorded over a 5-min period when patients were hemodynamically stable. The power-law model represents a power function relating frequency distribution to magnitude of effect (in this case, squared deviation from the mean heart rate). Plotting the data on a bi-logarithmic scale produces a regression line for each measurement, described in terms of r2, slope, and x-intercept. Comparison with other HRV measures included two time-domain measures (sd of the normal R-R intervals and the square root of the mean squared differences of successive normal R-R intervals), one frequency-domain method (power spectral analysis), and one nonlinear method (detrended fluctuation analysis).MEASUREMENTS AND RESULTS For the power-law model, patients exhibited a similar r2 of .87 (.09) (mean [sd]) and slope of -1.80 (0.29), regardless of the degree of OF. HRV could thus be described purely in terms of x-intercept, which demonstrated a left shift with increasing OF (p < .001). This was independent of age and heart rate. Loss of HRV with increasing OF was demonstrated by all methods; however, only the power-law model was able to discriminate between each OF group. Using the model, change in HRV in individual patients over successive days often concurred qualitatively with the change in OF status.CONCLUSION The power-law model is an appropriate measure of HRV in pediatric patients, being neither age nor heart rate sensitive. Loss of HRV occurs with increasing OF; this effect was better demonstrated by the model compared with other measures of HRV. [ABSTRACT FROM AUTHOR]
Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Novel method to quantify loss of heart rate variability in pediatric multiple organ failure.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Critical+Care+Medicine%22&quot;&gt;Critical Care Medicine&lt;/searchLink&gt;. Jul2003, Vol. 31 Issue 7, p2059-2067. 9p.
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  Data: *&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22HEART+beat%22&quot;&gt;HEART beat&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22MULTIPLE+organ+failure%22&quot;&gt;MULTIPLE organ failure&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22PEDIATRICS%22&quot;&gt;PEDIATRICS&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22HEMODYNAMICS%22&quot;&gt;HEMODYNAMICS&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: OBJECTIVE To develop a power-law model for measurement of heart rate variability (HRV) and to compare this model with established methods for measuring HRV in a group of children with organ failure (OF).DESIGN Prospective, observational study.SETTING Pediatric intensive care unit of a tertiary children&#39;&#39;s hospital.PATIENTS A total of 104 measurements were made on 50 patients (median age, 8 months; range, 2 days to 16 yrs) and categorized into three groups according to the number of simultaneous organs failing: 0-1 OF, 2 OF, and ≥3 OF.INTERVENTIONS Heart rate was recorded over a 5-min period when patients were hemodynamically stable. The power-law model represents a power function relating frequency distribution to magnitude of effect (in this case, squared deviation from the mean heart rate). Plotting the data on a bi-logarithmic scale produces a regression line for each measurement, described in terms of r2, slope, and x-intercept. Comparison with other HRV measures included two time-domain measures (sd of the normal R-R intervals and the square root of the mean squared differences of successive normal R-R intervals), one frequency-domain method (power spectral analysis), and one nonlinear method (detrended fluctuation analysis).MEASUREMENTS AND RESULTS For the power-law model, patients exhibited a similar r2 of .87 (.09) (mean [sd]) and slope of -1.80 (0.29), regardless of the degree of OF. HRV could thus be described purely in terms of x-intercept, which demonstrated a left shift with increasing OF (p &lt; .001). This was independent of age and heart rate. Loss of HRV with increasing OF was demonstrated by all methods; however, only the power-law model was able to discriminate between each OF group. Using the model, change in HRV in individual patients over successive days often concurred qualitatively with the change in OF status.CONCLUSION The power-law model is an appropriate measure of HRV in pediatric patients, being neither age nor heart rate sensitive. Loss of HRV occurs with increasing OF; this effect was better demonstrated by the model compared with other measures of HRV. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Critical Care Medicine is the property of Lippincott Williams &amp; Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder&#39;s express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1097/01.CCM.0000069539.65980.58
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      – Code: eng
        Text: English
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        PageCount: 9
        StartPage: 2059
    Subjects:
      – SubjectFull: HEART beat
        Type: general
      – SubjectFull: MULTIPLE organ failure
        Type: general
      – SubjectFull: PEDIATRICS
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      – SubjectFull: HEMODYNAMICS
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      – TitleFull: Novel method to quantify loss of heart rate variability in pediatric multiple organ failure.
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          Name:
            NameFull: Shane M. Tibby
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            NameFull: Helena Frndova
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            NameFull: Andrew Durward
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            NameFull: Peter N. Cox
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            – D: 01
              M: 07
              Text: Jul2003
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              Y: 2003
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            – TitleFull: Critical Care Medicine
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