Changes of heart rate variability during ventilator weaning.
OBJECTIVE
Despite the recognition that ventilator weaning is associated with a change in autonomic nervous system activity, there has not been any report concerning the change of heart rate variability (HRV), a reliable method to detect autonomic nervous system activity, in patients during weaning. The aim of this study was to investigate the change of autonomic nervous system activity during ventilator weaning by HRV analysis.


METHODS
Prospective study.


METHODS
A 16-bed medical ICU of a tertiary university hospital.


METHODS
Twenty-four patients receiving mechanical ventilation were included. Twelve patients with successful extubation after a spontaneous breathing trial (SBT) [T-piece trial] were classified as the success group; otherwise, the patients were placed in the failure group.


METHODS
None.


RESULTS
Variables, including the total power (TP), and the high-frequency (HF) and low-frequency (LF) components of HRV, were measured in three phases: assist/control mandatory ventilation, pressure support ventilation (PSV), and SBT. While shifting from PSV to SBT, the HRV components decreased significantly in the failure group (TP, p = 0.025; LF, p = 0.007; HF, p = 0.031), but not in the success group.


CONCLUSIONS
By HRV analysis, reduced HRV and vagal withdrawal of the autonomic nervous system activity are the main changes in patients with weaning failure.
Shen
Hsiu-Nien
HN
Department of Internal Medicine, En-Chu-Kong Hospital, Taipei, Taiwan.
Lin
Lian-Yu
LY
Chen
Kuan-Yu
KY
Kuo
Ping-Hung
PH
Yu
Chong-Jen
CJ
Wu
Huey-Dong
HD
Yang
Pan-Chyr
PC
D000368:Aged; D000369:Aged, 80 and over; D001341:Autonomic Nervous System / Q000502:physiology*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015300:Ventilator Weaning