Reduction of heart rate variability after colorectal resections

Haase, Oliver; Langelotz, Corinna; Scharfenberg, Mark; Schwenk, W.; Tsilimparis, Nikolaos

doi:10.1007/s00423-012-0903-2

Cited by 9 publications

(12 citation statements)

References 20 publications

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“…Our findings of a significant decrease in SDNN, pNN50 and rMSSD on the first postoperative night are in accordance with the other studies [13,14,17,19,20], but at variance with other studies [15,18]. Scheffler et al [18].…”

Section: Discussionsupporting

confidence: 92%

“…These two studies, however, only measured HRV during the first postoperative 24-36 h and the duration of the changes after major surgery is therefore not known. Changes in HRV in the peri/postoperative period after non-cardiac surgery in patients without known ischaemic heart disease have been described before [12][13][14][15][16][17][18][19][20]. These studies are heterogeneous in both design and the patients included.…”

Section: Discussionmentioning

confidence: 92%

“…found a trend towards increased pNN50 on the first postoperative night and decreased pNN50 on the second postoperative night. Haase et al [15] found a significantly reduced SDNN on the first postoperative night, which was normalized by the second postoperative night.…”

Section: Discussionmentioning

confidence: 97%

“…The studies are performed primarily after major surgery. The duration of observation is from 1 to 30 days postoperatively and some of the studies include patients with cancer [12][13][14][15][18][19][20] and others patients with benign disease [16,17].…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, in patients without ischaemic heart disease undergoing major non-cardiac surgery, it has been shown that there was lack of circadian variation in the ANS tone and reduced HRV [12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 98%

See 4 more Smart Citations

Lack of circadian variation and reduction of heart rate variability in women with breast cancer undergoing lumpectomy: a descriptive study

Hansen

Rosenberg

Gögenur

2013

Breast Cancer Res Treat

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Changes in the autonomic nervous system with increased sympathetic tone may be a cause of postoperative short-, and long-term cardiovascular complications. Heart rate variability (HRV) is assessed by Holter monitoring as a measure of autonomic tone and has not been investigated in patients with breast cancer undergoing surgery. We aimed to investigate evening- and night-time HRV after lumpectomy. Twelve patients were included in this descriptive study. HRV was measured the night before surgery (PREOP), the night after surgery (PO1) and 14 days after surgery (PO14) from 1900 to 0700 h. For calculation of HRV, time domain parameters (SDNN-standard deviation of all normal-to-normal (NN) intervals around the mean NN for the period of measurement, pNN50-percentage of beats where the change from one beat to the next is more than 50 ms, rMSSD-root mean square of successive differences) were used. We analyzed the variation of the overall time period and the circadian variation between evening and night (sympathetic vs. parasympathetic tonus). Mean heart rate increased from PREOP to PO1 (p < 0.001) and also increased between PREOP and PO14 (p < 0.05). SDNN (p < 0.001) and PNN50 (p < 0.001) decreased from PREOP to PO1. There was also a significant decrease between PREOP and PO14 for both parameters (p < 0.005 and p = 0.05 respectively). SDNN increased from PO1 to PO14 (p < 0.005). rMSSD decreased from PREOP to PO1 (p < 0.001). A circadian variation was found in the mean heart rate for all three monitoring periods (p < 0.005). Circadian variation was also present on PREOP for pNN50 (p ≤ 0.05) and rMSSD (p < 0.05). This variation was missing for both PO1 and PO14. Patients had a shift of autonomic tone with reduced parasympathetic activity and lack of circadian variation 14 days after lumpectomy.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 3 more Smart Citations

Lack of circadian variation and reduction of heart rate variability in women with breast cancer undergoing lumpectomy: a descriptive study

Hansen

Rosenberg

Gögenur

2013

Breast Cancer Res Treat

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Low intraoperative heart rate volatility is associated with early postoperative mortality in general surgical patients: a retrospective case–control study

Mandel-Portnoy

Levin

Bansilal

et al. 2015

J Clin Monit Comput

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Heart rate volatility (HRVO) is hypothesized to be a physiological measure of sympathetic activity and is defined by the standard deviation (SD) of the heart rate (HR) in beats per minutes (BPM) over fixed time intervals. To investigate the relationship between low HRVO (SD < 0.5 BPM) during surgical procedures and mortality within 48 h post-procedure. We retrospectively reviewed all adult general surgical procedures performed at our center from January 1, 2003 through July 1, 2013 to identify patients who died within 48 h post-procedure. Demographic, heart rate, and mortality data were extracted from the electronic anesthesia record. Propensity score analysis was used to find matching controls based on age, gender, ASA score, anesthesia type, Charlson index, procedure type, emergency status, year, use of preoperative beta blocker, hypertension, diabetes, atrial fibrillation and heart failure. HRVO was calculated for each 5 min interval as the SD of all HR's within that interval. Negative binomial regression was then used to model the count of intervals with HRVO < 0.5 BPM for the duration of the surgery. During the 10 year study period, 283 patients died within 48 h of procedure finish. These patients were matched to 566 patients who did not die within 48 h after procedure. Patients who died had a 39 % increase in frequency of low HRVO episodes compared to patients who survived (RR 1.39, 95 % CI 1.13-1.72; p = 0.003). Low HRVO during surgical procedure is associated with increased mortality risk within 48 h after procedure. Strategies to identify HRVO early and modify it may lead to improvement in outcomes.

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Evaluation of a wrist-worn photoplethysmography monitor for heart rate variability estimation in patients recovering from laparoscopic colon resection

Rinne

Miri

Oksala

et al. 2022

J Clin Monit Comput

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To evaluate the accuracy of heart rate variability (HRV) parameters obtained with a wrist-worn photoplethysmography (PPG) monitor in patients recovering from minimally invasive colon resection to investigate whether PPG has potential in postoperative patient monitoring. 31 patients were monitored for three days or until discharge or reoperation using a wrist-worn PPG monitor (PulseOn, Finland) with a Holter monitor (Faros 360, Bittium Biosignals, Finland) as a reference measurement device. Beat-to-beat intervals (BBI) and HRV information collected by PPG were compared with RR intervals (RRI) and HRV obtained from the ECG reference after removing artefacts and ectopic beats. The beat-to-beat mean error (ME) and mean absolute error (MAE) of good quality heartbeat intervals obtained by wrist PPG were estimated as − 1.34 ms and 10.4 ms respectively. A significant variation in the accuracy of the HRV parameters was found. In the time domain, SDNN (9.11%), TRI (11.4%) and TINN (11.1%) were estimated with low relative MAE, while RMSSD (34.3%), pNN50 (139%) and NN50 (188%) had higher errors. The logarithmic parameters in the frequency domain (VLF Log, LF Log and HF Log) exhibited the lowest relative error, and for non-linear parameters, SD2 (7.5%), DFA α1 (8.25%) and DFA α2 (4.71%) were calculated much more accurately than SD1 (34.3%). The wrist PPG shows some potential for use in a clinical setting. The accuracy of several HRV parameters analyzed post hoc was found sufficient to be used in further studies concerning postoperative recovery of patients undergoing laparoscopic colon resection, although there were large errors in many common HRV parameters such as RMSSD, pNN50 and NN50, rendering them unusable.ClinicalTrials.gov Identifier: NCT04996511, August 9, 2021, retrospectively registered

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Reduction of heart rate variability after colorectal resections

Abstract: Colorectal resections significantly influence the HRV course. The autonomic regulation is reduced in the early postoperative time and all parameters return to baseline until the third day.

Cited by 9 publications

References 20 publications

Lack of circadian variation and reduction of heart rate variability in women with breast cancer undergoing lumpectomy: a descriptive study

Lack of circadian variation and reduction of heart rate variability in women with breast cancer undergoing lumpectomy: a descriptive study

Low intraoperative heart rate volatility is associated with early postoperative mortality in general surgical patients: a retrospective case–control study

Evaluation of a wrist-worn photoplethysmography monitor for heart rate variability estimation in patients recovering from laparoscopic colon resection

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