The cardiac R-R variation and sympathetic skin response in the intensive care unit.
OBJECTIVE
The central and peripheral nervous systems are often affected in intensive care unit (ICU) patients, especially those with prolonged assisted ventilation and sepsis or systemic inflammatory response syndrome (SIRS). The autonomic nervous system, however, has been under-investigated in such patients. We evaluated autonomic nervous system (ANS) function in 29 ICU patients with various neurological disorders.


METHODS
Testing involved cardiac R-R variation (CRRV) as an index of parasympathetic function and the sympathetic skin response (SSR) for sympathetic assessment.


RESULTS
Only those 8 patients with sepsis-related neuropathy or encephalopathy had abnormal CRRV, while the SSR was absent in all but 2 patients.


CONCLUSIONS
Our preliminary study revealed a high incidence of autonomic dysfunction in ICU patients with various neurological disorders.
Bolton
Charles
C
From the Division of Neurology. University of Western Ontario, London, Ontario, Canada.
Thompson
Jillian
J
Bernardi
Linda
L
Voll
Christopher
C
Young
Bryan
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D017776:Autonomic Pathways / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011115:Polyneuropathies / Q000175:diagnosis / Q000503:physiopathology; D011446:Prospective Studies; D012867:Skin / Q000294:innervation / Q000503:physiopathology; D017779:Sympathetic Fibers, Postganglionic / Q000503:physiopathology; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications* / Q000503:physiopathology; D012122:Ventilators, Mechanical / Q000009:adverse effects