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The Cardiac R-R Variation and Sympathetic Skin Response in the Intensive Care Unit

Published online by Cambridge University Press:  02 December 2014

Charles Bolton ,
Jillian Thompson ,
Linda Bernardi ,
Christopher Voll  and
Bryan Young
Charles Bolton
Affiliation:
The Division of Neurology, University of Western Ontario, London, Ontario
Jillian Thompson
Affiliation:
The Division of Neurology, University of Western Ontario, London, Ontario
Linda Bernardi
Affiliation:
The Division of Neurology, University of Western Ontario, London, Ontario
Christopher Voll
Affiliation:
The University of Saskatchewan, Saskatoon, Saskatchewan, Canada
Bryan Young
Affiliation:
The Division of Neurology, University of Western Ontario, London, Ontario
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Abstract

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Background and Purpose:

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.

Résumé:

RÉSUMÉ:

La variation cardiaque R-R et la réponse cutanée sympathique chez des patients de l'unité de soins intensifs. Contexte et objectif : Le système nerveux central et le système nerveux périphérique sont souvent atteints chez les patients hospitalisés à l'unité de soins intensifs (USI), surtout chez ceux qui sont sous ventilation assistée prolongée et ceux qui sont atteints de septicémie ou d'un syndrome de réaction inflammatoire généralisée (SIRS). Cependant, le système nerveux autonome (SNA) a été peu étudié chez ces patients. Nous avons étudié la fonction du SNA chez 29 patients de l'USI atteints de différents problèmes neurologiques. Méthodes : Nous avons étudié la variation de l'intervalle R-R (VIRR) comme indice de la fonction parasympathique et la réponse cutanée sympathique (RCS) pour la fonction sympathique. Résultats : Seuls les 8 patients atteints de neuropathie ou d'encéphalopathie reliée à une septicémie avaient une VIRR anormale et la RCS était présente chez deux patients seulement. Conclusions : Cette étude préliminaire a révélé une incidence élevée de dysfonction autonome chez les patients atteints de différents troubles neurologiques qui sont hospitalisés à l'USI.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue 3 , August 2007 , pp. 313 - 315
Copyright
Copyright © The Canadian Journal of Neurological 2007

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