Role of heart rate variability in patients with hypertensive cerebral hemorrhage complicated by pulmonary infection after tracheotomy

doi:10.16138/j.1673-6087.2024.04.06

Abstract

Abstract:

Objective To investigate the relationship between heart rate variability (HRV) and pulmonary infection after tracheotomy in patients with hypertensive cerebral hemorrhage (HICH), to provide reference for clinical diagnosis and treatment. Methods The clinical data of 101 HICH patients who underwent tracheotomy from February 2018 to December 2022 were analyzed retrospectively. The patients were divided into infection group and non-infection group according to the complicated pulmonary infection. The general data, inflammatory markers and HRV indexes of the two groups were compared. Pearson correlation was used to analyze the relationship between HRV and pulmonary infection after tracheotomy in HICH patients. Results In 101 patients with HICH, there were 54 cases (53.5%) developed pulmonary infection within 7 d after tracheotomy. There was a statistically significant difference in preoperative Glasgow coma scale (GCS) between the two groups (P<0.05). The cytokines such as interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and procalcitonin (PCT) in the infected group were higher than those in the non-infection group. The HRV indexes including the standard deviation of RR interval for all sinus beats within 24 h standard deviation of normal to normal interval (SDNN), 24 h average SDNN (SDANN), the root mean square of successive differences in adjacent RR interval(RMSSD), the percentage of beats with percentage of adjacent normal to normal intervals differing by more than 50 ms(PNN50), high frequency power (HF) low frequency power (LF) were all lower than those of non-infection group (P<0.05). The Pearson correlation test showed that HRV was negatively correlated with IL-6, CRP, TNF-α and PCT (P<0.05). Conclusions HRV in patients with HICH is associated with pulmonary infection after tracheotomy. The lower values of SDNN, SDANN, RMSSD, PNN50, HF, LF suggest an increased risk of pulmonary infection.

Key words: Hypertensive cerebral hemorrhage, Tracheotomy, Pulmonary infection, Heart rate variability

CLC Number:

R563.1
R743

CHEN Li, WANG Shaowei, WANG Yunqi. Role of heart rate variability in patients with hypertensive cerebral hemorrhage complicated by pulmonary infection after tracheotomy[J]. Journal of Internal Medicine Concepts & Practice, 2024, 19(04): 249-253.

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项目	未感染组（n=47）	感染组（n=54）	χ²/t/Z	P
性别[n(%)]			0.004	0.951
男	29（51.7）	33（61.1）
女	18（38.3）	21（38.9）
年龄（岁）	61.00±10.04	61.57±11.25	0.269	0.789
合并糖尿病史	8（17.0）	12（22.2）	0.428	0.513
收缩压（mmHg）	169.40±11.11	168.63±12.30	0.330	0.742
舒张压（mmHg）	101.62±8.33	100.24±8.14	0.838	0.404
术前GCS（分）	10.00（10.00，11.00）	8.00（7.75，9.00）	7.307	<0.001
术前血肿量（mL）	46.81±4.25	46.87±4.36	0.072	0.943

项目	未感染组（n=47）	感染组（n=54）	t	P
IL-6（ng/L）	67.04±8.24	81.64±8.97	8.477	<0.001
CRP（mg/L）	60.83±7.42	71.85±8.23	7.025	<0.001
TNF-α（ng/L）	38.69±5.32	47.43±5.64	7.974	<0.001
PCT（ng/mL）	0.64±0.13	0.97±0.18	10.933	<0.001
SDNN（ms）	90.32±10.46	61.24±8.71	15.052	<0.001
SDANN（ms）	132.00±16.52	109.17±18.14	6.575	<0.001
RMSSD（ms）	26.02±6.23	18.26±4.13	7.262	<0.001
PNN50（%）	4.11±0.36	3.44±0.29	10.227	<0.001
HF（ms²）	342.89±12.25	286.70±11.42	23.847	<0.001
LF（ms²）	923.64±24.05	714.69±16.47	50.190	<0.001

项目	IL-6		CRP		TNF-α		PCT
项目	r	P	r	P	r	P	r	P
SDNN	-0.513	<0.001	-0.568	<0.001	-0.474	<0.001	-0.576	<0.001
SDANN	-0.348	<0.001	-0.364	<0.001	-0.242	0.015	-0.352	<0.001
RMSSD	-0.340	0.001	-0.391	<0.001	-0.314	0.001	-0.476	<0.001
PNN50	-0.442	<0.001	-0.387	<0.001	-0.496	<0.001	-0.533	<0.001
HF	-0.564	<0.001	-0.513	<0.001	-0.574	<0.001	-0.714	<0.001
LF	-0.632	<0.001	-0.551	<0.001	-0.595	<0.001	-0.721	<0.001