Luyao Zhang1, Jing Zhou, Lu Ke, Yao Nie, Zhihui Tong, Weiqin Li, Jieshou Li. 1. Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, Jiangsu Province, China, mariolw@outlook.com.
Abstract
BACKGROUND: Infected pancreatic necrosis (IPN) and multiple organ dysfunction syndrome (MODS) are major complications of acute pancreatitis which determine disease severity and outcome. AIMS: The aim of this study is to investigate the value of admission heart rate variability as a marker of IPN or MODS in severe acute pancreatitis (SAP) patients. METHODS: Forty-one SAP patients within 72 h of symptoms onset were included in this prospective observational study. General demographics, laboratory data and the acute physiology and chronic health evaluation (APACHE) II scores were recorded at admission. 5-minute ECG signals were obtained at the same time for heart rate variability analyses to assess SAP severity. RESULTS: The baseline heart rate variability measurements, levels of low frequency/high frequency (LF/HF) were significantly lower whereas high frequency norm (nHF) levels were significantly higher in patients who present with IPN and MODS or died (P < 0.01). Low frequency (LF) levels were lower in patients who present with IPN or MODS as compared to patients without these complications. Levels of low frequency norm (nLF) were lower in MODS and non-survival patients. nHF and LF/HF were good predictors of IPN and MODS, superior to procalcitonin. nHF and LF/HF were better than APACHE II in predicting IPN and LF/HF showed superiority over APACHE II in the prediction of MODS. CONCLUSIONS: Admission heart rate variability is a good marker of IPN and MODS in SAP patients.
BACKGROUND:Infected pancreatic necrosis (IPN) and multiple organ dysfunction syndrome (MODS) are major complications of acute pancreatitis which determine disease severity and outcome. AIMS: The aim of this study is to investigate the value of admission heart rate variability as a marker of IPN or MODS in severe acute pancreatitis (SAP) patients. METHODS: Forty-one SAP patients within 72 h of symptoms onset were included in this prospective observational study. General demographics, laboratory data and the acute physiology and chronic health evaluation (APACHE) II scores were recorded at admission. 5-minute ECG signals were obtained at the same time for heart rate variability analyses to assess SAP severity. RESULTS: The baseline heart rate variability measurements, levels of low frequency/high frequency (LF/HF) were significantly lower whereas high frequency norm (nHF) levels were significantly higher in patients who present with IPN and MODS or died (P < 0.01). Low frequency (LF) levels were lower in patients who present with IPN or MODS as compared to patients without these complications. Levels of low frequency norm (nLF) were lower in MODS and non-survival patients. nHF and LF/HF were good predictors of IPN and MODS, superior to procalcitonin. nHF and LF/HF were better than APACHE II in predicting IPN and LF/HF showed superiority over APACHE II in the prediction of MODS. CONCLUSIONS: Admission heart rate variability is a good marker of IPN and MODS in SAP patients.
Authors: Hendrik Schmidt; Ursula Müller-Werdan; Thomas Hoffmann; Darrel P Francis; Massimo F Piepoli; Mathias Rauchhaus; Roland Prondzinsky; Harald Loppnow; Michael Buerke; Dirk Hoyer; Karl Werdan Journal: Crit Care Med Date: 2005-09 Impact factor: 7.598
Authors: R Moreno; J L Vincent; R Matos; A Mendonça; F Cantraine; L Thijs; J Takala; C Sprung; M Antonelli; H Bruining; S Willatts Journal: Intensive Care Med Date: 1999-07 Impact factor: 17.440
Authors: Bettina M Rau; Esko A Kemppainen; Andrew A Gumbs; Markus W Büchler; Karl Wegscheider; Claudio Bassi; Pauli A Puolakkainen; Hans G Beger Journal: Ann Surg Date: 2007-05 Impact factor: 12.969