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Continuous perioperative heart rate variability monitoring in video-assisted thoracoscopic surgery lobectomy—a pilot study
Journal of Clinical Monitoring and Computing ( IF 2.0 ) Pub Date : 2023-05-27 , DOI: 10.1007/s10877-023-01016-2
Mikkel Nicklas Frandsen 1 , Lin Huang 2 , René Horsleben Petersen 2 , Nicolai Bang Foss 3 , Jesper Mehlsen 1 , Henrik Kehlet 1
Affiliation  

Heart rate variability (HRV) is a measure of cardiac autonomic modulation and is potentially related to hypotension, postoperative atrial fibrillation, and orthostatic intolerance. However, there is a lack of knowledge on which specific time points and indices to measure. To improve future study design, there is a need for procedure-specific studies in an enhanced recovery after surgery (ERAS) video-assisted thoracic surgery (VATS) lobectomy setting, and for continuous measurement of perioperative HRV. HRV was measured continuously from 2 days before until 9 days after VATS lobectomy in 28 patients. After VATS lobectomy, with median length of stay = 4 days, the standard deviation between normal-to-normal beats and the total power of HRV were reduced for 8 days during the night and day times, while low-to-high frequency variation and detrended fluctuation analysis were stable. This is the first detailed study to show that HRV measures of total variability were reduced following ERAS VATS lobectomy, while other measures were more stable. Further, preoperative HRV measures showed circadian variation. The patch was well tolerated among participants, but actions should be taken to ensure proper mounting of the measuring device. These results demonstrate a valid design platform for future HRV studies in relation to postoperative outcomes.



中文翻译:

电视胸腔镜肺叶切除术围手术期持续心率变异性监测——一项试点研究

心率变异性 (HRV) 是衡量心脏自主调节的指标,可能与低血压、术后心房颤动和体位不耐受有关。然而,缺乏对哪些具体时间点和指标进行衡量的知识。为了改进未来的研究设计,需要在加速康复外科 (ERAS) 电视胸腔镜手术 (VATS) 肺叶切除术中进行针对具体手术的研究,并持续测量围手术期 HRV。对 28 名患者进行 VATS 肺叶切除术前 2 天至术后 9 天连续测量 HRV。VATS 肺叶切除术后,中位住院时间 = 4 天,正常至正常心跳之间的标准差和 HRV 总功率在夜间和白天时间持续 8 天降低,而从低到高的频率变化和去趋势波动分析稳定。这是第一项详细研究,表明 ERAS VATS 肺叶切除术后 HRV 总变异性指标有所降低,而其他指标则更加稳定。此外,术前 HRV 测量显示昼夜节律变化。参与者对贴片的耐受性良好,但应采取措施确保测量设备正确安装。这些结果为未来与术后结果相关的 HRV 研究提供了一个有效的设计平台。

更新日期:2023-05-27
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