Respiratory Rate Variability as a Prognostic Factor in Hospitalized Patients Transferred to the Intensive Care Unit

• Published in: Curēus (Palo Alto, CA) CA), 2018-01, Vol.10 (1), p.e2100-e2100
• Main Authors: Garrido, Daniel, Assioun, Justin J, Keshishyan, Anahit, Sanchez-Gonzalez, Marcos A, Goubran, Bishoy
• Format: Article
• Language: English
• Subjects: Chronic obstructive pulmonary disease; Heart failure; Hospitals; Intensive care; Internal Medicine; Medical prognosis; Mortality; Physiology; Pulmonology; Sepsis; Variance analysis; Vital signs
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.2100

Introduction Increasing mortality rates within the intensive care unit (ICU) is an ever growing problem, ultimately leading to increases in the cost of healthcare expenditures. Currently, there are attempts to use guidelines in the hospital setting to predict overall mortality in critically ill patients. However, a predictor of subsequent ICU admissions remains to be explored. Recent data has shown the importance of monitoring respiratory rate variability (RRV) as a useful predictor of the deterioration of patients. Respiratory rate, in comparison to blood pressure or pulse rate, is deemed as the better determinant in identifying high-risk patients. Aim Our study aims to assess the role of RRV monitoring as a potential prognostic marker predictive of ICU admission. Results There was a significant (p = 0.009) increase in RRV between the third and fourth set of respiratory rates prior to ICU admission, such that coefficient of variation percentage (CV%) increased from 0.3% (95% confidence interval (CI): 0.09 - 0.42) to 0.7% (95% CI: 0.04 - 0.9) about 12 hours before admission to the ICU independent from diagnosis. Conclusion Using elevated RRV as a signal may be a useful prognostic tool in providing early intervention, thus reducing the incidence of subsequent morbidity and mortality in patients that might necessitate an ICU admission.