Key result
BiPAP significantly increased parasympathetic activity in patients with decompensated heart failure, evidenced by an increase in the standard deviation of R-R intervals from 31.0 ms to 40.3 ms.
Why the study?
Does BiPAP improve autonomic tone in hospitalized patients with decompensated heart failure?
Cross-Sectional (n=20)
No
Does BiPAP improve autonomic tone in hospitalized patients with decompensated heart failure?
Acute application of BiPAP in patients with decompensated heart failure significantly enhances vagal tone, which may be beneficial in reducing arrhythmia risk.
Answers are grounded in this paper and cite their sources.
Should not yet change BiPAP use in decompensated HF; hypothesis-generating for autonomic effects and requires randomized confirmation.
[Purpose] This study evaluated the effect of Bilevel Positive Airway (BiPAP) on the autonomic control of heart rate, assessed by heart rate variability (HRV), in patients hospitalized with decompensated heart failure. [Subjects and Methods] This prospective cross-sectional study included 20 subjects (age: 69±8 years, 12 male, left ventricular ejection fraction: 36 ±8%) diagnosed with heart failure who were admitted to a semi-intensive care unit with acute decompensation. Date was collected for HRV analysis during: 10 minutes spontaneous breathing in the resting supine position; 30 minutes breathing with BiPAP application (inspiratory pressure = 20 cmH2O and expiratory pressure = 10 cmH2O); and 10 minutes immediately after removal of BiPAP, during the return to spontaneous breathing. [Results] Significantly higher values for indices representative of increased parasympathetic activity were found in the time and frequency domains as well as in nonlinear Poincaré analysis during and after BiPAP in comparison to baseline. Linear HRV analysis: standard deviation of the average of all R-R intervals in milliseconds = 30.99±4.4 pre, 40.3±6.2 during, and 53.3±12.5 post BiPAP. Non-linear HRV analysis: standard deviations parallel in milliseconds = 8.31±4.3 pre, 12.9±5.8 during, and 22.8 ±6.3 post BiPAP. [Conclusion] The present findings demonstrate that BiPAP enhances vagal tone in patients with heart failure, which is beneficial for patients suffering from acute decompensation.
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Lacerda et al. (2016) conducted a cross-sectional in Decompensated heart failure (n=20). Bilevel Positive Airway Pressure (BiPAP) vs. Spontaneous breathing (baseline) was evaluated on Standard deviation of the average of all R-R intervals (STDRR) (p=<0.05). BiPAP significantly increased parasympathetic activity in patients with decompensated heart failure, evidenced by an increase in the standard deviation of R-R intervals from 31.0 ms to 40.3 ms.
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