Core temperature variation is associated with heart rate variability independent of cardiac index: A study of 278 trauma patients

Abstract Purpose The purpose of this study is to determine if temperature extremes are associated with reduced heart rate variability (HRV) and “cardiac uncoupling.” Materials and Methods This was a retrospective, observational cohort study performed on 278 trauma intensive care unit admissions that...

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Bibliographic Details
Published in:Journal of critical care 2011-10, Vol.26 (5), p.534.e9-534.e17
Main Authors: Mowery, Nathan T., MD, Morris, John A., MD, Jenkins, Judith M., MSN, Ozdas, Asli, PhD, Norris, Patrick R., PhD
Format: Article
Language:English
Subjects:
Body temperature
Body Temperature - physiology
Cardiac output
Cardiac Output - physiology
College admissions
Critical Care
Female
Fever
Head injuries
Heart rate
Heart Rate - physiology
Heart rate variability
Hospitalization
Hospitals
Humans
Intensive care
Male
Middle Aged
Monitoring systems
Monitoring, Physiologic
Physiologic monitoring
Pulmonary arteries
Retrospective Studies
Temperature
Trauma
Variables
Wounds and Injuries - physiopathology
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Summary:Abstract Purpose The purpose of this study is to determine if temperature extremes are associated with reduced heart rate variability (HRV) and “cardiac uncoupling.” Materials and Methods This was a retrospective, observational cohort study performed on 278 trauma intensive care unit admissions that had continuous HR, cardiac index (CI), and core temperature data from “thermodilution” Swan-Ganz catheter. Dense (captured second-by-second) physiologic data were divided into 5-minute intervals (N = 136 133; 11 344 hours of data). Mean CI, mean temperature, and integer HR SD were computed for each interval. Critically low HRV was defined as HR SD from 0.3 to 0.6 beats per minute. Temperature extremes were defined as less than 36°C or greater than 39°C. Results Low HRV and CI vary with temperature. Temperature extremes are associated with increased risk for critically low HRV (odds ratio, >1.8). Cardiac index increases with temperature until hyperthermia (>40°C). At temperature extremes, changes in CI were not explained solely by changes in HR. Conclusions The conclusions of this study are (1) temperature extremes are associated with low HRV, potentially reflecting cardiac autonomic dysfunction; (2) CI increases with temperature; and (3) HRV provides additional physiologic information unobtainable via current invasive cardiac monitoring and current vital signs.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2010.11.008