Heart rate variability measurement offers a low-cost, non-invasive method to assess autonomic dysfunction, serving as a potential diagnostic and prognostic tool in perioperative and critical care.
Does measurement of heart rate variability provide diagnostic and prognostic utility in surgical and critically ill patients?
Heart rate variability is a simple, non-invasive method to assess autonomic dysfunction, offering potential diagnostic and prognostic value in anesthesia and intensive care.
The autonomic nervous system (ANS) plays an important role in the human response to various internal and external stimuli, which can modify homeostasis, and exerts a tight control on essential functions such as circulation, respiration, thermoregulation and hormonal secretion. ANS dysfunction may complicate the perioperative course in the surgical patient undergoing anesthesia, increasing morbidity and mortality, and, therefore, it should be considered as an additional risk factor during pre-operative evaluation. Furthermore, ANS dysfunction may complicate the clinical course of critically ill patients admitted to intensive care units, in the case of trauma, sepsis, neurologic disorders and cardiovascular diseases, and its occurrence adversely affects the outcome. In the care of these patients, the assessment of autonomic function may provide useful information concerning pathophysiology, risk stratification, early prognosis prediction and treatment strategies. Given the role of ANS in the maintenance of systemic homeostasis, anesthesiologists and intensivists should recognize as critical the evaluation of ANS function. Measurement of heart rate variability (HRV) is an easily accessible window into autonomic activity. It is a low-cost, non-invasive and simple to perform method reflecting the balance of the ANS regulation of the heart rate and offers the opportunity to detect the presence of autonomic neuropathy complicating several illnesses. The present review provides anesthesiologists and intensivists with a comprehensive summary of the possible clinical implications of HRV measurements, suggesting that autonomic dysfunction testing could potentially represent a diagnostic and prognostic tool in the care of patients both in the perioperative setting as well as in the critical care arena.
Mazzeo et al. (Thu,) conducted a review in Patients undergoing anesthesia or admitted to intensive care. Heart rate variability (HRV) measurement was evaluated. Heart rate variability measurement offers a low-cost, non-invasive method to assess autonomic dysfunction, serving as a potential diagnostic and prognostic tool in perioperative and critical care.