在重症COVID-19肺炎患者的心率变化和死亡率
Chalermchai Komaenthammasophon1,2, Monvasi Pachinburavan1, Ronpichai Chokesuwattanaskul2,3
1Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
心率变化 (HRV) 的降低,特别是正常至正常间隔 (SDNN) 的标准偏差,与重症COVID-19肺炎患者的死亡率较高有关. 较低的SDNN也与炎症标志物增加相关,这表明其预后价值.
科学领域:
- 临界护理医学 临界护理医学
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
背景情况:
- 心率变化 (HRV) 预测心血管和败血症患者的死亡率.
- 降低HRV与增加的死亡率和发病率有关.
- 在COVID-19肺炎中HRV的预后意义仍然不清楚.
研究的目的:
- 评估HRV参数对严重COVID-19肺炎的预后效用.
- 在这些患者中评估HRV参数与炎症标志物之间的相关性.
主要方法:
- 从三级重症监护室注册了患有严重疾病的COVID-19肺炎患者.
- 使用遥测和霍尔特分析记录和分析了24小时的HRV参数.
- 使用ROC曲线分析以获得最佳HRV截止值和Cox回归以预测死亡率.
主要成果:
- 与幸存者 (105.95 ms) 相比,非幸存者的SDNN较低 (70.30 ms).
- SDNN预测了住院死亡率,AUC为0.67 (95%CI为0.55至0.79).
- 对SDNN<70毫秒的死亡率进行调整后的风险比为3.70 (95% CI 1.34-10.24).
结论:
- 降低SDNN与重症COVID-19肺炎患者的死亡率有关.
- 较低的SDNN可能表明住院死亡风险较高.
- 人力资源病毒参数,特别是SDNN,在严重的COVID-19中显示出作为预后生物标志物的潜力.
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