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Heart Rate Variability During Weaning from Invasive Mechanical Ventilation: A Systematic Review
Giovanni Giordano1,2, Francesco Alessandri1,2, Antonella Tosi2
1Department of General and Specialistic Surgery, "Sapienza" University of Rome, 00185, Rome, Italy.
Heart Rate Variability (HRV) monitoring shows promise in predicting successful weaning from mechanical ventilation in critically ill adults. Specific HRV indices may help identify patients at risk of weaning failure.
Area of Science:
- Critical Care Medicine
- Physiology
- Medical Technology
Background:
- The predictive value of Heart Rate Variability (HRV) for mechanical ventilation weaning outcomes is debated.
- Critically ill adult patients undergoing weaning from invasive mechanical ventilation (IMV) are the focus of this investigation.
- Existing research presents conflicting evidence regarding HRV's role in weaning success.
Purpose of the Study:
- To systematically review and analyze Heart Rate Variability (HRV) indices in critically ill adult patients during the weaning process from invasive mechanical ventilation (IMV).
- To assess the potential of HRV analysis in predicting the success or failure of weaning from IMV.
- To identify specific HRV parameters that may reliably indicate weaning outcomes.
Main Methods:
- Systematic review of randomized controlled trials and observational studies.
- Searched PubMed and Scopus databases from inception to March 2023.
- Included studies involving critically ill adult patients undergoing weaning from IMV, focusing on HRV analysis.
Main Results:
- Seven studies with 342 patients were included.
- All studies reported significant changes in at least one HRV parameter during weaning.
- Low Frequency (LF), High Frequency (HF), and LF/HF ratio showed potential for reliable prediction of weaning outcomes.
Conclusions:
- HRV modifications are observed during mechanical ventilation weaning.
- Specific HRV indices show promise for predicting weaning outcomes in critically ill patients.
- Point-of-care HRV monitoring could aid in early detection of patients at risk for weaning failure.
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