Association between autonomic control indexes and mortality in subjects admitted to intensive care unit

Abstract This study checks whether autonomic markers derived from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP) and from their interactions with spontaneous or mechanical respiration (R) are associated with mortality in patients admitted to intensive care unit (I...

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Autores principales:	Alberto Porta, Riccardo Colombo, Andrea Marchi, Vlasta Bari, Beatrice De Maria, Giovanni Ranuzzi, Stefano Guzzetti, Tommaso Fossali, Ferdinando Raimondi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/12153c02747443399b669ebf127e8475
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spelling	oai:doaj.org-article:12153c02747443399b669ebf127e84752021-12-02T12:32:21ZAssociation between autonomic control indexes and mortality in subjects admitted to intensive care unit10.1038/s41598-018-21888-82045-2322https://doaj.org/article/12153c02747443399b669ebf127e84752018-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-21888-8https://doaj.org/toc/2045-2322Abstract This study checks whether autonomic markers derived from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP) and from their interactions with spontaneous or mechanical respiration (R) are associated with mortality in patients admitted to intensive care unit (ICU). Three-hundred consecutive HP, SAP and R values were recorded during the first day in ICU in 123 patients. Population was divided into survivors (SURVs, n = 83) and non-survivors (NonSURVs, n = 40) according to the outcome. SURVs and NonSURVs were aged- and gender-matched. All subjects underwent modified head-up tilt (MHUT) by tilting the bed back rest segment to 60°. Autonomic control indexes were computed using time-domain, spectral, cross-spectral, complexity, symbolic and causality techniques via univariate, bivariate and conditional approaches. SAP indexes derived from time-domain, model-free complexity and symbolic approaches were associated with the endpoint, while none of HP variability markers was. The association was more powerful during MHUT. Linear cross-spectral and causality indexes were useless to separate SURVs from NonSURVs, while nonlinear bivariate symbolic markers were successful. When indexes were combined with clinical scores, only SAP variance provided complementary information. Cardiovascular control variability indexes, especially when derived after an autonomic challenge such as MHUT, can improve mortality risk stratification in ICU.Alberto PortaRiccardo ColomboAndrea MarchiVlasta BariBeatrice De MariaGiovanni RanuzziStefano GuzzettiTommaso FossaliFerdinando RaimondiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-13 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Alberto Porta Riccardo Colombo Andrea Marchi Vlasta Bari Beatrice De Maria Giovanni Ranuzzi Stefano Guzzetti Tommaso Fossali Ferdinando Raimondi Association between autonomic control indexes and mortality in subjects admitted to intensive care unit
description	Abstract This study checks whether autonomic markers derived from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP) and from their interactions with spontaneous or mechanical respiration (R) are associated with mortality in patients admitted to intensive care unit (ICU). Three-hundred consecutive HP, SAP and R values were recorded during the first day in ICU in 123 patients. Population was divided into survivors (SURVs, n = 83) and non-survivors (NonSURVs, n = 40) according to the outcome. SURVs and NonSURVs were aged- and gender-matched. All subjects underwent modified head-up tilt (MHUT) by tilting the bed back rest segment to 60°. Autonomic control indexes were computed using time-domain, spectral, cross-spectral, complexity, symbolic and causality techniques via univariate, bivariate and conditional approaches. SAP indexes derived from time-domain, model-free complexity and symbolic approaches were associated with the endpoint, while none of HP variability markers was. The association was more powerful during MHUT. Linear cross-spectral and causality indexes were useless to separate SURVs from NonSURVs, while nonlinear bivariate symbolic markers were successful. When indexes were combined with clinical scores, only SAP variance provided complementary information. Cardiovascular control variability indexes, especially when derived after an autonomic challenge such as MHUT, can improve mortality risk stratification in ICU.
format	article
author	Alberto Porta Riccardo Colombo Andrea Marchi Vlasta Bari Beatrice De Maria Giovanni Ranuzzi Stefano Guzzetti Tommaso Fossali Ferdinando Raimondi
author_facet	Alberto Porta Riccardo Colombo Andrea Marchi Vlasta Bari Beatrice De Maria Giovanni Ranuzzi Stefano Guzzetti Tommaso Fossali Ferdinando Raimondi
author_sort	Alberto Porta
title	Association between autonomic control indexes and mortality in subjects admitted to intensive care unit
title_short	Association between autonomic control indexes and mortality in subjects admitted to intensive care unit
title_full	Association between autonomic control indexes and mortality in subjects admitted to intensive care unit
title_fullStr	Association between autonomic control indexes and mortality in subjects admitted to intensive care unit
title_full_unstemmed	Association between autonomic control indexes and mortality in subjects admitted to intensive care unit
title_sort	association between autonomic control indexes and mortality in subjects admitted to intensive care unit
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/12153c02747443399b669ebf127e8475
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Association between autonomic control indexes and mortality in subjects admitted to intensive care unit

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