Analysis of heart rate variability and cardiovascular response in the alveolar recruitment manoeuver in acute respiratory distress syndrome

  • Audrey Borghi-Silva Federal University of Sao Carlos
  • Gustavo Rodrigues das Chagas
  • Viviany Mendes Borges
  • Michel Silva Reis
  • Eliane Maria de Carvalho
Keywords: Heart rate variability, alveolar recruitment manoeuvre, acute respiratory distress syndrome, positive end-expiratory pressure

Abstract

Objective: To assess the cardiac autonomic modulation through heart rate variability (HRV) in response to alveolar recruitment manoeuvre (ARM) of patients with acute respiratory distress syndrome (ARDS).

Methods: We have studied four patients with ARDS. The RR intervals were recorded before, during and after alveolar recruitment manoeuvre (ARM), along with blood pressure (BP), oxygen arterial pressure (PaO₂), oxygen inspired fraction (FiO2) heart rate (HR), oxygen peripheral saturation (SpO₂), compliance (Comp), resistance (Res), and PaO₂/FiO₂ ratio. HRV was analysed by using linear time-domain (TD) and non-linear methods. The former consisted of RMSSD (root mean square of squares of differences between successive R-Ri values) and SDNN (standard deviation of the mean of normal R-Ri values) in the frequency domain (FD) regarding low (LF) and high frequency (HF) bands as well as LF/HF ratio, whereas the latter consisted of short- (SD1) and long-term (SD2) records, and de-trended fluctuation analysis of short- (DFAα1) and long-term (DFAα2) duration.

Results: We found significant increases in the variables Comp and PaO₂/FiO₂ compared to the rest period, and in SatO₂ at the end of ARM. In addition,  recovery and decreased Res were also found at the end of ARM compared to the rest period. HRV showed a significant increase in index DFAα1 during ARM as well as a tendency of decrease in RMSSD and increase in SDNN, including increase in SD1, SD2, and DFAα2 as well.

Conclusion: HRV undergoes changes in response to ARM with a tendency of decrease in the parasympathetic activity and increase in the total variability during ARM.

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Author Biography

Audrey Borghi-Silva, Federal University of Sao Carlos
Professor at Federal University of Sao Carlos
Published
15-09-2016
How to Cite
BORGHI-SILVA, A.; DAS CHAGAS, G. R.; BORGES, V. M.; REIS, M. S.; DE CARVALHO, E. M. Analysis of heart rate variability and cardiovascular response in the alveolar recruitment manoeuver in acute respiratory distress syndrome. Journal of Respiratory and CardioVascular Physical Therapy, v. 3, n. 2, p. 30-39, 15 Sep. 2016.
Section
Artigos