Attenuated autonomic function in multiple organ dysfunction syndrome across three age groups
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Hendrik Schmidt
Abstract
Multiple organ dysfunction syndrome (MODS) is the failure of several organs after a trigger event. The mortality is high, at up to 70%. We hypothesize that autonomic dysfunction may substantially contribute to the development of MODS and speculate that there is an age dependence of autonomic dysfunction in MODS. A total of 90 consecutively admitted MODS patients were assigned to this study. Three variables of autonomic function were analyzed: heart rate variability (HRV), baroreflex sensitivity (BRS) and chemoreflex sensitivity (CRS). The patient cohort was divided into three age groups. The main finding was that BRS, CRS and almost all indices of HRV were attenuated in comparison to normal range data and there was no age dependence for HRV indices or CRS, but there was for BRS. In conclusion, autonomic function in MODS is attenuated. The influence of MODS on autonomic function overwhelms the age dependence of autonomic function observed in healthy subjects.
References
1 Task Force of the European Society of Cardiology and North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Eur Heart J 1996; 17: 354–381.Suche in Google Scholar
2 Cohen J. The immunopathogenesis of sepsis. Nature2002; 420: 885–891.10.1038/nature01326Suche in Google Scholar
3 Garrard CS, Kontoyannis DA, Piepoli M. Spectral analysis of heart rate variability in sepsis syndrome. Clin Auton Res1993; 3: 5–13.10.1007/BF01819137Suche in Google Scholar
4 Godin PJ, Buchman TG. Uncoupling of biological oscillators: a complementary hypothesis concerning the pathogenesis of multiple organ dysfunction syndrome. Crit Care Med1996; 24: 1107–1116.10.1097/00003246-199607000-00008Suche in Google Scholar
5 Hennersdorf M, Perings C, Niebich V, Hillebrand S, Vester EG, Strauer BE. Chemoreflex sensitivity in patients with survived sudden cardiac arrest and prior myocardial infarction. Pacing Clin Electrophysiol2000; 23: 457–462.10.1111/j.1540-8159.2000.tb00827.xSuche in Google Scholar
6 La Rovere MT, Bigger TJ Jr, Marcus FI, Mortara A, Schwartz PJ, ATRAMI investigators. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. Lancet1998; 351: 478–484.10.1016/S0140-6736(97)11144-8Suche in Google Scholar
7 Moerer O, Schmid A, Hofmann M, et al. Direct costs of severe sepsis in three German intensive care units based on retrospective electronic patient record analysis of resource use. Intensive Care Med2002; 28: 1440–1446.10.1007/s00134-002-1429-9Suche in Google Scholar PubMed
8 Nolan J, Batin PD, Andrews R, et al. Prospective study of heart rate variability and mortality in chronic heart failure – results of the United Kingdom Heart Evaluation and Assessment of Risk Trial (UK-HEART). Circulation1998; 98: 1510–1516.10.1161/01.CIR.98.15.1510Suche in Google Scholar
9 Pikkujämsä SM, Mäkikallio TH, Sourander LB, et al. Cardiac interbeat interval dynamics from childhood to senescence. Comparison of conventional and new measures based on fractals and chaos theory. Circulation1999; 100: 393–399.10.1161/01.CIR.100.4.393Suche in Google Scholar PubMed
10 Ponikowski P, Chua TP, Piepoli M, et al. Augmented peripheral chemosensitivity as a potential input to baroreflex impairment and autonomic imbalance in chronic heart failure. Circulation1997; 96: 2586–2594.10.1161/01.CIR.96.8.2586Suche in Google Scholar PubMed
11 Schmidt H, Hennen R, Keller A, et al. Association of statin therapy and increased survival in patients with multiorgan dysfunction syndrome. Intensive Care Med2006; 32: 1248–1251.10.1007/s00134-006-0246-ySuche in Google Scholar PubMed
12 Schmidt H, Müller-Werdan U, Hoffmann T, et al. Autonomic dysfunction predicts mortality in patients with multiple organ dysfunction syndrome of different age groups. Crit Care Med2005; 33: 1994–2002.10.1097/01.CCM.0000178181.91250.99Suche in Google Scholar
13 Schmidt H, Müller-Werdan U, Nuding S, et al. Impaired chemoreflex sensitivity in adult patients with multiple organ dysfunction syndrome – the potential role of disease severity. Intensive Care Med2004; 30: 665–672.10.1007/s00134-003-2131-2Suche in Google Scholar PubMed
14 Schmidt H, Werdan K, Müller-Werdan U. Autonomic dysfunction in the ICU patient. Curr Opin Crit Care2001; 7: 314–322.10.1097/00075198-200110000-00002Suche in Google Scholar PubMed
15 Smyth H, Sleight P, Pickering G. Reflex regulation of arterial pressure during sleep in man. Circ Res1969; 24: 109–121.10.1161/01.RES.24.1.109Suche in Google Scholar
16 Winchell RJ, Hoyt DB. Spectral analysis of heart rate variability in the ICU. J Surg Res1996; 63: 11–16.10.1006/jsre.1996.0214Suche in Google Scholar PubMed
©2006 by Walter de Gruyter Berlin New York
Artikel in diesem Heft
- ESGCO 2006 Conference and Meeting of the European Study Group on Cardiovascular Oscillations, Jena, Germany, May 15–17, 2006
- Cardiovascular Oscillations: from methods and models to clinical applications
- Circadian and ultradian rhythms in heart rate variability
- Influence of age, body mass index, and blood pressure on the carotid intima-media thickness in normotensive and hypertensive patients
- Multivariate and multidimensional analysis of cardiovascular oscillations in patients with heart failure
- Multivariate and multiorgan analysis of cardiorespiratory variability signals: the CAP sleep case
- Role of the autonomic nervous system in generating non-linear dynamics in short-term heart period variability
- Non-linear dynamic analysis of the cardiac rhythm during transient myocardial ischemia
- Complex autonomic dysfunction in cardiovascular, intensive care, and schizophrenic patients assessed by autonomic information flow
- Low HRV entropy is strongly associated with myocardial infarction
- Revisiting the potential of time-domain indexes in short-term HRV analysis
- Fractal dimension in health and heart failure
- Spatiotemporal correlation analyses: a new procedure for standardisation of DC magnetocardiograms
- Changes in heart rate variability of athletes during a training camp
- The missing link between cardiovascular rhythm control and myocardial cell modeling
- Model of the sino-atrial and atrio-ventricular nodes of the conduction system of the human heart
- Modelling long-term heart rate variability: an ARFIMA approach
- Clinical correlates of non-linear indices of heart rate variability in chronic heart failure patients
- Recurrence analysis of nocturnal heart rate in sleep apnea patients
- Normalized correlation dimension for heart rate variability analysis
- Complexity of heart rate fluctuations in near-term sheep and human fetuses during sleep
- Differences between heart rate and blood pressure variability in schizophrenia
- Influence of sympathetic vascular regulation on heart-rate scaling structure: spinal cord lesion as a model of progressively impaired autonomic control
- Increase in regularity of fetal heart rate variability with age
- Fetal heart rate variability in growth restricted fetuses
- Frequency modulation between low- and high-frequency components of the heart rate variability spectrum
- Mixed predictability and cross-validation to assess non-linear Granger causality in short cardiovascular variability series
- Assessment of spatial organization in the atria during paroxysmal atrial fibrillation and adrenergic stimulation
- Attenuated autonomic function in multiple organ dysfunction syndrome across three age groups
- Central vasopressin V1a and V1b receptors modulate the cardiovascular response to air-jet stress in conscious rats
- Heart rate asymmetry by Poincaré plots of RR intervals
- Analyses of cardiovascular oscillations for enhanced diagnosis and risk stratification in cardiac diseases and disorders
Artikel in diesem Heft
- ESGCO 2006 Conference and Meeting of the European Study Group on Cardiovascular Oscillations, Jena, Germany, May 15–17, 2006
- Cardiovascular Oscillations: from methods and models to clinical applications
- Circadian and ultradian rhythms in heart rate variability
- Influence of age, body mass index, and blood pressure on the carotid intima-media thickness in normotensive and hypertensive patients
- Multivariate and multidimensional analysis of cardiovascular oscillations in patients with heart failure
- Multivariate and multiorgan analysis of cardiorespiratory variability signals: the CAP sleep case
- Role of the autonomic nervous system in generating non-linear dynamics in short-term heart period variability
- Non-linear dynamic analysis of the cardiac rhythm during transient myocardial ischemia
- Complex autonomic dysfunction in cardiovascular, intensive care, and schizophrenic patients assessed by autonomic information flow
- Low HRV entropy is strongly associated with myocardial infarction
- Revisiting the potential of time-domain indexes in short-term HRV analysis
- Fractal dimension in health and heart failure
- Spatiotemporal correlation analyses: a new procedure for standardisation of DC magnetocardiograms
- Changes in heart rate variability of athletes during a training camp
- The missing link between cardiovascular rhythm control and myocardial cell modeling
- Model of the sino-atrial and atrio-ventricular nodes of the conduction system of the human heart
- Modelling long-term heart rate variability: an ARFIMA approach
- Clinical correlates of non-linear indices of heart rate variability in chronic heart failure patients
- Recurrence analysis of nocturnal heart rate in sleep apnea patients
- Normalized correlation dimension for heart rate variability analysis
- Complexity of heart rate fluctuations in near-term sheep and human fetuses during sleep
- Differences between heart rate and blood pressure variability in schizophrenia
- Influence of sympathetic vascular regulation on heart-rate scaling structure: spinal cord lesion as a model of progressively impaired autonomic control
- Increase in regularity of fetal heart rate variability with age
- Fetal heart rate variability in growth restricted fetuses
- Frequency modulation between low- and high-frequency components of the heart rate variability spectrum
- Mixed predictability and cross-validation to assess non-linear Granger causality in short cardiovascular variability series
- Assessment of spatial organization in the atria during paroxysmal atrial fibrillation and adrenergic stimulation
- Attenuated autonomic function in multiple organ dysfunction syndrome across three age groups
- Central vasopressin V1a and V1b receptors modulate the cardiovascular response to air-jet stress in conscious rats
- Heart rate asymmetry by Poincaré plots of RR intervals
- Analyses of cardiovascular oscillations for enhanced diagnosis and risk stratification in cardiac diseases and disorders
