Association between heart rate variability and perioperative systemic inflammatory response
Authors:
P. Reimer 1; M. Káňová 1; J. Máca 1; P. Ševčík 1; M. Burda 2; M. Adamus 3
Authors‘ workplace:
Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Ostrava a Lékařská fakulta Ostravské univerzity
1; Ústav pro výzkum a aplikace fuzzy modelování, Ostravská univerzita
2; Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Olomouc a Lékařská fakulta Univerzity Palackého v Olomouci
3
Published in:
Anest. intenziv. Med., 29, 2018, č. 1, s. 3-13
Category:
Anaesthesia - Originale paper
Overview
Objective:
Colorectal surgery significantly affects homeostasis. The aim of the study was to identify patients with high inflammatory response to surgical injury, objectivized by the levels of C-reactive protein (CRP), interleukin-6 (IL-6) and white cell count (WCC) measured within 48 hours after the beginning of surgery by pre-operative measurement of heart rate variability (HRV).
Design:
Prospective, observational study.
Setting:
Department of Anesthesiology and Intensive Care Medicine, University Hospital
Materials and methods:
HRV was measured during orthostatic load one day before surgery. The patients were divided according to the HRV results into two groups: CAR (with cardiac autonomic reactivity, n=23), and NCAR (without cardiac autonomic reactivity, n=30). Serum levels of CRP, IL-6 and WCC were obtained at 0, 12 (only IL-6), 24 and 48 hours after the beginning of surgery.
Results:
The observed CAR and NCAR were significantly different at the levels of CRP at T0 (6.5±5.1 mg/L vs. 16.4±23.2 mg/L, p<0.05), T24 (70.5±33.6 mg/L vs. 95.7±49.1 mg/L, p<0.05), T48 (103.1±42.4 mg/L vs. 159.0±63.4 mg/L, p<0.001), and IL-6 at T12 (79.3±42.2 pg/mL vs. 248.2±285.2 pg/mL, p<0.05), T24 (68.0±28.0 pg/mL vs. 239.6 ± 245.8 pg/mL, p<0.001), and T48 (39.5±18.4 pg/mL vs. 195.5±162.9 pg/mL; p<0.0001). There was no significant difference in WCC between CAR and NCAR patients.
Conclusion:
HRV is a method for identifying patients with high perioperative pro-inflammatory response. Statistical differences in CRP and IL-6 levels between the studied groups increased over time. IL-6 was statistically significantly different already at T24, thus enabled earlier identification of patients with higher pro-inflammatory response when compared to CRP.
Keywords:
heart rate variability – systemic inflammatory response – C-reactive protein – interleukin-6 – leukocytes – colorectal surgery
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Anaesthesiology, Resuscitation and Inten Intensive Care MedicineArticle was published in
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