Association between autonomic control indexes and mortality in subjects admitted to intensive care unit

Alberto Porta, Riccardo Colombo, Andrea Marchi, Vlasta Bari, Beatrice De Maria, Giovanni Ranuzzi, Stefano Guzzetti, Tommaso Fossali, Ferdinando Raimondi

Research output: Contribution to journalArticle

Abstract

This study checks whether autonomic markers derived from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP) and from their interactions with spontaneous or mechanical respiration (R) are associated with mortality in patients admitted to intensive care unit (ICU). Three-hundred consecutive HP, SAP and R values were recorded during the first day in ICU in 123 patients. Population was divided into survivors (SURVs, n = 83) and non-survivors (NonSURVs, n = 40) according to the outcome. SURVs and NonSURVs were aged- and gender-matched. All subjects underwent modified head-up tilt (MHUT) by tilting the bed back rest segment to 60°. Autonomic control indexes were computed using time-domain, spectral, cross-spectral, complexity, symbolic and causality techniques via univariate, bivariate and conditional approaches. SAP indexes derived from time-domain, model-free complexity and symbolic approaches were associated with the endpoint, while none of HP variability markers was. The association was more powerful during MHUT. Linear cross-spectral and causality indexes were useless to separate SURVs from NonSURVs, while nonlinear bivariate symbolic markers were successful. When indexes were combined with clinical scores, only SAP variance provided complementary information. Cardiovascular control variability indexes, especially when derived after an autonomic challenge such as MHUT, can improve mortality risk stratification in ICU.

Original languageEnglish
Pages (from-to)3486
JournalScientific Reports
Volume8
Issue number1
DOIs
Publication statusPublished - Feb 22 2018

Fingerprint

Intensive Care Units
Arterial Pressure
Blood Pressure
Mortality
Head
Causality
Bed Rest
Survivors
Respiration
Population

Cite this

Association between autonomic control indexes and mortality in subjects admitted to intensive care unit. / Porta, Alberto; Colombo, Riccardo; Marchi, Andrea; Bari, Vlasta; De Maria, Beatrice; Ranuzzi, Giovanni; Guzzetti, Stefano; Fossali, Tommaso; Raimondi, Ferdinando.

In: Scientific Reports, Vol. 8, No. 1, 22.02.2018, p. 3486.

Research output: Contribution to journalArticle

Porta, Alberto ; Colombo, Riccardo ; Marchi, Andrea ; Bari, Vlasta ; De Maria, Beatrice ; Ranuzzi, Giovanni ; Guzzetti, Stefano ; Fossali, Tommaso ; Raimondi, Ferdinando. / Association between autonomic control indexes and mortality in subjects admitted to intensive care unit. In: Scientific Reports. 2018 ; Vol. 8, No. 1. pp. 3486.
@article{9aecc56bfc774398bf3966b909d7b172,
title = "Association between autonomic control indexes and mortality in subjects admitted to intensive care unit",
abstract = "This study checks whether autonomic markers derived from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP) and from their interactions with spontaneous or mechanical respiration (R) are associated with mortality in patients admitted to intensive care unit (ICU). Three-hundred consecutive HP, SAP and R values were recorded during the first day in ICU in 123 patients. Population was divided into survivors (SURVs, n = 83) and non-survivors (NonSURVs, n = 40) according to the outcome. SURVs and NonSURVs were aged- and gender-matched. All subjects underwent modified head-up tilt (MHUT) by tilting the bed back rest segment to 60°. Autonomic control indexes were computed using time-domain, spectral, cross-spectral, complexity, symbolic and causality techniques via univariate, bivariate and conditional approaches. SAP indexes derived from time-domain, model-free complexity and symbolic approaches were associated with the endpoint, while none of HP variability markers was. The association was more powerful during MHUT. Linear cross-spectral and causality indexes were useless to separate SURVs from NonSURVs, while nonlinear bivariate symbolic markers were successful. When indexes were combined with clinical scores, only SAP variance provided complementary information. Cardiovascular control variability indexes, especially when derived after an autonomic challenge such as MHUT, can improve mortality risk stratification in ICU.",
author = "Alberto Porta and Riccardo Colombo and Andrea Marchi and Vlasta Bari and {De Maria}, Beatrice and Giovanni Ranuzzi and Stefano Guzzetti and Tommaso Fossali and Ferdinando Raimondi",
year = "2018",
month = "2",
day = "22",
doi = "10.1038/s41598-018-21888-8",
language = "English",
volume = "8",
pages = "3486",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",
number = "1",

}

TY - JOUR

T1 - Association between autonomic control indexes and mortality in subjects admitted to intensive care unit

AU - Porta, Alberto

AU - Colombo, Riccardo

AU - Marchi, Andrea

AU - Bari, Vlasta

AU - De Maria, Beatrice

AU - Ranuzzi, Giovanni

AU - Guzzetti, Stefano

AU - Fossali, Tommaso

AU - Raimondi, Ferdinando

PY - 2018/2/22

Y1 - 2018/2/22

N2 - This study checks whether autonomic markers derived from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP) and from their interactions with spontaneous or mechanical respiration (R) are associated with mortality in patients admitted to intensive care unit (ICU). Three-hundred consecutive HP, SAP and R values were recorded during the first day in ICU in 123 patients. Population was divided into survivors (SURVs, n = 83) and non-survivors (NonSURVs, n = 40) according to the outcome. SURVs and NonSURVs were aged- and gender-matched. All subjects underwent modified head-up tilt (MHUT) by tilting the bed back rest segment to 60°. Autonomic control indexes were computed using time-domain, spectral, cross-spectral, complexity, symbolic and causality techniques via univariate, bivariate and conditional approaches. SAP indexes derived from time-domain, model-free complexity and symbolic approaches were associated with the endpoint, while none of HP variability markers was. The association was more powerful during MHUT. Linear cross-spectral and causality indexes were useless to separate SURVs from NonSURVs, while nonlinear bivariate symbolic markers were successful. When indexes were combined with clinical scores, only SAP variance provided complementary information. Cardiovascular control variability indexes, especially when derived after an autonomic challenge such as MHUT, can improve mortality risk stratification in ICU.

AB - This study checks whether autonomic markers derived from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP) and from their interactions with spontaneous or mechanical respiration (R) are associated with mortality in patients admitted to intensive care unit (ICU). Three-hundred consecutive HP, SAP and R values were recorded during the first day in ICU in 123 patients. Population was divided into survivors (SURVs, n = 83) and non-survivors (NonSURVs, n = 40) according to the outcome. SURVs and NonSURVs were aged- and gender-matched. All subjects underwent modified head-up tilt (MHUT) by tilting the bed back rest segment to 60°. Autonomic control indexes were computed using time-domain, spectral, cross-spectral, complexity, symbolic and causality techniques via univariate, bivariate and conditional approaches. SAP indexes derived from time-domain, model-free complexity and symbolic approaches were associated with the endpoint, while none of HP variability markers was. The association was more powerful during MHUT. Linear cross-spectral and causality indexes were useless to separate SURVs from NonSURVs, while nonlinear bivariate symbolic markers were successful. When indexes were combined with clinical scores, only SAP variance provided complementary information. Cardiovascular control variability indexes, especially when derived after an autonomic challenge such as MHUT, can improve mortality risk stratification in ICU.

U2 - 10.1038/s41598-018-21888-8

DO - 10.1038/s41598-018-21888-8

M3 - Article

VL - 8

SP - 3486

JO - Scientific Reports

JF - Scientific Reports

SN - 2045-2322

IS - 1

ER -