Heart rate variability as a predictor of intraoperative autonomic nervous system homeostasis

• Verfasst von: Keim, Ole C. [VerfasserIn]
• Verfasst von: Bolwin, Lennart [VerfasserIn]
• Verfasst von: Feldmann, Robert Enrico [VerfasserIn]
• Verfasst von: Thiel, Manfred [VerfasserIn]
• Verfasst von: Benrath, Justus [VerfasserIn]
• Titel: Heart rate variability as a predictor of intraoperative autonomic nervous system homeostasis
• Verf.angabe: Ole C. Keim, Lennart Bolwin, Robert E. Feldmann, Jr., Manfred Thiel, Justus Benrath
• Jahr: 2024
• Umfang: 9 S.
• Fussnoten: Online veröffentlicht: 13. Juli 2024 ; Gesehen am 18.11.2024
• Titel Quelle: Enthalten in: Journal of clinical monitoring and computing
• Ort Quelle: Dordrecht [u.a.] : Springer Science + Business Media B.V., 1985
• Jahr Quelle: 2024
• Band/Heft Quelle: (2024)
• ISSN Quelle: 1573-2614
• DOI: doi:10.1007/s10877-024-01190-x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Autonomic nervous system
• Sach-SW: Depth of anesthesia
• Sach-SW: Heart rate variability
• Sach-SW: Minimum alveolar concentration
• Sach-SW: Narcotrend index
• Sach-SW: Sevoflurane
• K10plus-PPN: 1908867922

Abstract

The aim of the proof-of-concept study is to investigate the level of concordance between the heart rate variability (HRV), the EEG-based Narcotrend Index as a surrogate marker for the depth of hypnosis, and the minimal alveolar concentration (MAC) of the inhalation anesthetic sevoflurane across the entire course of a surgical procedure. This non-blinded cross-sectional study recorded intraoperative HRV, Narcotrend Index, and MAC in 31 male patients during radical prostatectomy using the Da-Vinci robotic-assisted surgical system at Mannheim University Medical Center. The degree of concordance was calculated using repeated measures correlation with the R package (rmcorr) and presented using the rmcorr coefficient (rrm). The Narcotrend Index correlates significantly across all measures with the time-dependent parameter of HRV, the standard deviation of the means of RR intervals (SDNN) (rrm = 0.2; p < 0.001), the frequency-dependent parameters low frequency (LF) (rrm = 0.09; p = 0.04) and the low frequency/high frequency ratio (LF/HF ratio) (rrm = 0.11; p = 0.002). MAC correlated significantly negatively with the time-dependent parameter of heart rate variability, SDNN (rrm = -0.28; p < 0.001), the frequency-dependent parameter LF (rrm = -0.06; p < 0.001) and the LF/HF ratio (rrm = -0.18; p < 0.001) and the Narcotrend Index (rrm = -0.49; p < 0.001) across all measures. HRV mirrors the trend of the Narcotrend Index used to monitor depth of hypnosis and the inhibitory influence of the anesthetic sevoflurane on the autonomic nervous system. Therefore, HRV can provide essential information about the homeostasis of the autonomic nervous system during general anesthesia. DRKS00024696, March 9th, 2021.