Laan, L. van der (Lindsy) (2018) The influence of vasoactive medication on heart rate variability in patients presenting with sepsis at the emergency department. thesis, Medicine.
Full text available on request.Abstract
Aim The aim of this study was to obtain more insight in the influence of vasoactive medication on HRV in septic patients presenting at the emergency department (ED), specifically the influence of beta-blockers, calcium channel blockers and RAS inhibitors. Methods This was a prospective observational study in adult non-trauma patients presenting with suspected sepsis, and at least 2 Systemic Inflammatory Response Syndrome criteria (SIRS), at the ED of a tertiary care teaching hospital. Eligible patients were equipped with a mobile patient monitor, which continuously records vital signs (ECG, heart rate, blood pressure, respiratory rate and oxygen saturation) during the first 48 hours of admission. HRV was analysed in time and frequency domain. HRV was compared between the two groups, 1) patients using no vasoactive medication and 2) patients using vasoactive medication. Vasoactive medication was defined as the use of beta-blockers, calcium channel blockers or RAS-inhibitors. Thereafter subgroup analyses were performed with the same groups, only group 2 split into three subgroups: use of beta-blockers, calcium channel blockers or RAS-inhibitors. Outcomes/ results For the final analysis, 71 patients were included, 71.8% presented with mild sepsis and 28.2% with severe sepsis. The main finding was a significant higher RMSSD, pNN50, Total Power, LF and HF in the group using vasoactive medication compared to the group using no of vasoactive medication (Table 7). Beta-blockers, calcium channel blockers and RAS-inhibitors had no significant effect on nearly all HRV parameters (Table 8). Conclusion In HRV analysis, there should be corrected for the use of vasoactive medication.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and ter Maaten, Prof. Dr. J.C. and Second supervisor: and Quinten, Ir. Drs. V.M. and Emergency Department, University Medical Center Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:53 |
| Last Modified: | 25 Jun 2020 10:53 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1397 |
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