Abstract des BISp

Verf. geben zunächst Hintergrundinformationen zu Entstehung und Ursachen sowie Merkmalen und Auswirkungen von Sepsis und Multiorgandysfunktionssyndrom (MODS) und verdeutlichen die Rolle der Herzfrequenzvariabilität (HRV) bei der Erkrankung. Anschließend werden die verschiedenen Messwerte und Analyseverfahren der HRV aufgezeigt und eine Studie vorgestellt, in der durch die serielle Messung der HRV bei MODS-Patienten die Veränderungen der HRV im Krankheitsverlauf untersucht wurde. (bo)

Abstract des Autors

The "multiple organ dysfunction syndrome" (MODS) is the consecutive failure of vital human organs yielding to an extremely increased mortality. This syndrome is triggered by several factors, such as cardiogenic shock, pneumonia or, mostly, sepsis. A MODS elicits a disruption of interorgan communication which can be characterized mainly by heart rate variability (HRV). HRV has been shown to be an excellent predictor of mortality in MODS. Thus, we hypothesized that HRV changes during ICU stay in accordance with the severity of illness. 14 consecutive MODS patients were enrolled into the present study. The serial course of HRV was evaluated. Severity of illness was assessed by APACHE II score within 48 hours after admission to ICU. A 24-hours Holter ECG was recorded and HRV analyzed at admission (T1), after 3 days (T2) and after 14 days (T3). Serials measurements of HRV could not reveal significant differences considering the individual moments of assessment. Nevertheless, there was a loss of more than 50 of patients during follow up due to various reasons. Serial assessment of HRV in a small group of MOOS patients did not show any differences in HRV. The hypothesis that HRV changes during ICU stay in accordance with the severity of illness was not supported, but larger studies need to confirm this idea.