期刊名称：Journal of Respiratory and CardioVascular Physical Therapy
印刷版ISSN：2238-4677
出版年度：2016
卷号：3
期号：2
页码：30-39
语种：English
出版社：Journal of Respiratory and CardioVascular Physical Therapy
摘要：Objective: To assess the cardiac autonomic modulation through heart rate variability (HRV) in response to alveolar recruitment manoeuvre (ARM) of patients with acute respiratory distress syndrome (ARDS). Methods: We have studied four patients with ARDS. The RR intervals were recorded before, during and after alveolar recruitment manoeuvre (ARM), along with blood pressure (BP), oxygen arterial pressure (PaO₂), oxygen inspired fraction (FiO 2 ) heart rate (HR), oxygen peripheral saturation (SpO₂), compliance (Comp), resistance (Res), and PaO₂/FiO₂ ratio. HRV was analysed by using linear time-domain (TD) and non-linear methods. The former consisted of RMSSD (root mean square of squares of differences between successive R-Ri values) and SDNN (standard deviation of the mean of normal R-Ri values) in the frequency domain (FD) regarding low (LF) and high frequency (HF) bands as well as LF/HF ratio, whereas the latter consisted of short- (SD1) and long-term (SD2) records, and de-trended fluctuation analysis of short- (DFAα1) and long-term (DFAα2) duration. Results: We found significant increases in the variables Comp and PaO₂/FiO₂ compared to the rest period, and in SatO₂ at the end of ARM. In addition, recovery and decreased Res were also found at the end of ARM compared to the rest period. HRV showed a significant increase in index DFAα1 during ARM as well as a tendency of decrease in RMSSD and increase in SDNN, including increase in SD1, SD2, and DFAα2 as well. Conclusion: HRV undergoes changes in response to ARM with a tendency of decrease in the parasympathetic activity and increase in the total variability during ARM.
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