Key result
Dynamic HRV shifts during mechanical ventilation weaning may help predict extubation outcomes.
Why the study?
The role of heart rate variability indices in predicting the outcome of the weaning process from invasive mechanical ventilation remains a subject of debate.
Does Heart Rate Variability (HRV) analysis predict the outcome of weaning from invasive mechanical ventilation in critically ill adult patients?
Systematic Review (n=342)
Does Heart Rate Variability (HRV) analysis predict the outcome of weaning from invasive mechanical ventilation in critically ill adult patients?
Heart Rate Variability indices, particularly LF, HF, and the LF/HF ratio, show significant changes during weaning from mechanical ventilation and may serve as promising non-invasive predictors of weaning outcomes in critically ill patients.
HRV monitoring may aid weaning predictions in ventilated ICU patients; leaves open routine adoption pending larger prospective validation.
Background: The role of Heart Rate Variability (HRV) indices in predicting the outcome of the weaning process remains a subject of debate. The aim of this study is to investigate HRV analysis in critically ill adult patients undergoing weaning from invasive mechanical ventilation (IMV). Methods: The protocol of this systematic review was registered with PROSPERO (CRD42024485800). We searched PubMed and Scopus databases from inception till March 2023 to identify randomized controlled trials and observational studies investigating HRV analysis in critically ill adult patients undergoing weaning from invasive mechanical ventilation. Our primary outcome was to investigate HRV changes occurring during the weaning from IMV. Results: Seven studies (n = 342 patients) were included in this review. All studies reported significant changes in at least one HRV parameter. The indices Low Frequency (LF), High Frequency (HF), and LF/HF ratio seem to be the most promising in predicting the outcome of weaning with reliability. Some HRV indices showed modification in response to different ventilator settings or modalities. Conclusions: Available data report HRV modifications during the process of weaning and suggest a promising role of some HRV indices in predicting weaning outcomes in critically ill patients. Point-of-care HRV monitoring systems might help to early detect patients at risk of weaning failure.
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Giordano et al. (2024) conducted a systematic review in Critically ill adult patients undergoing weaning from invasive mechanical ventilation (n=342). Heart Rate Variability (HRV) indices vs. Successful vs unsuccessful weaning was evaluated on HRV changes occurring during the weaning from IMV. Heart rate variability indices, particularly Low Frequency, High Frequency, and the LF/HF ratio, significantly change during weaning from mechanical ventilation and may help predict weaning outcomes.
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