Early heart rate variability evaluation enables to predict ICU patients' outcome.

Journal: Scientific reports
PMID: 35169170

Abstract

Heart rate variability (HRV) is a mean to evaluate cardiac effects of autonomic nervous system activity, and a relation between HRV and outcome has been proposed in various types of patients. We attempted to evaluate the best determinants of such variation in survival prediction using a physiological data-warehousing program. Plethysmogram tracings (PPG) were recorded at 75 Hz from the standard monitoring system, for a 2 h period, during the 24 h following ICU admission. Physiological data recording was associated with metadata collection. HRV was derived from PPG in either the temporal and non-linear domains. 540 consecutive patients were recorded. A lower LF/HF, SD2/SD1 ratios and Shannon entropy values on admission were associated with a higher ICU mortality. SpO2/FiO2 ratio and HRV parameters (LF/HF and Shannon entropy) were independent correlated with mortality in the multivariate analysis. Machine-learning using neural network (kNN) enabled to determine a simple decision tree combining the three best determinants (SDNN, Shannon Entropy, SD2/SD1 ratio) of a composite outcome index. HRV measured on admission enables to predict outcome in the ICU or at Day-28, independently of the admission diagnosis, treatment and mechanical ventilation requirement.Trial registration: ClinicalTrials.gov identifier NCT02893462.

Authors

  • Laetitia Bodenes
    Service de Médecine Intensive et Réanimation, Medical Intensive Care, CHRU de Brest-La Cavale Blanche, 29609, Brest Cedex, France. laetitia.bodenes@chu-brest.fr.
  • Quang-Thang N'Guyen
    Oxynov Inc, Technopole Brest Iroise, 135 rue Claude Chappe, 29280, Plouzané, France.
  • Raphaël Le Mao
    EA 3878, Département de Médecine Interne, Vasculaire et Pneumologie, Université de Bretagne Occidentale, CHRU de Brest-La Cavale Blanche, Brest, France.
  • Nicolas Ferrière
    Service de Médecine Intensive et Réanimation, Medical Intensive Care, CHRU de Brest-La Cavale Blanche, 29609, Brest Cedex, France.
  • Victoire Pateau
    Service de Médecine Intensive et Réanimation, Medical Intensive Care, CHRU de Brest-La Cavale Blanche, 29609, Brest Cedex, France.
  • François Lellouche
    Centre de Recherche de l'Institut, Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada.
  • Erwan L'Her
    Service de Médecine Intensive et Réanimation, Medical Intensive Care, CHRU de Brest-La Cavale Blanche, 29609, Brest Cedex, France.

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