Spontaneous blood pressure oscillations in mechanically ventilated patients with sepsis
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Spontaneous blood pressure oscillations in mechanically ventilated patients with sepsis. / Berg, Ronan M G; Plovsing, Ronni R; Greve, Anders M; Christiansen, Claus Bohn; Toksvang, Linea N; von Holstein-Rathlou, Niels-Henrik; Møller, Kirsten.
In: Blood Pressure Monitoring, Vol. 21, No. 2, 04.2016, p. 75-9.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Spontaneous blood pressure oscillations in mechanically ventilated patients with sepsis
AU - Berg, Ronan M G
AU - Plovsing, Ronni R
AU - Greve, Anders M
AU - Christiansen, Claus Bohn
AU - Toksvang, Linea N
AU - von Holstein-Rathlou, Niels-Henrik
AU - Møller, Kirsten
PY - 2016/4
Y1 - 2016/4
N2 - OBJECTIVE: In the present hypothesis-generating study, we investigated whether spontaneous blood pressure oscillations are suppressed to lower frequencies, and whether abolished oscillations are associated with an adverse outcome in mechanically ventilated patients with sepsis.METHODS: We retrospectively subjected invasive steady-state blood pressure recordings from 65 mechanically ventilated patients with sepsis to spectral analysis. Modified spectral bands were visually identified by plotting spectral power against frequency.RESULTS: Modified middle-frequency and low-frequency (MF' and LF') oscillations were absent in 9% and 22% of the patients, respectively. In patients in whom spontaneous blood pressure oscillations were preserved, the MF' oscillations occurred at 0.021 Hz (median, interquartile range 0.013-0.030), whereas the LF' oscillations occurred at 0.009 Hz (median, interquartile range 0.006-0.010). The absence of LF' oscillations was associated with a higher 30-day mortality [50 vs. 18%, hazard ratio, 3.6 (95% confidence interval: 1.4-9.8), P=0.01].CONCLUSION: Spontaneous blood pressure oscillations in mechanically ventilated septic patients may be suppressed to lower frequencies than previously reported for spontaneously breathing, healthy humans. Patients in whom the resultant changes in blood pressure (MF' and LF' oscillations) are abolished may have a higher risk of an adverse outcome. This may reflect suppression of the pressor area in the brainstem with subsequent sympathetic dysfunction.
AB - OBJECTIVE: In the present hypothesis-generating study, we investigated whether spontaneous blood pressure oscillations are suppressed to lower frequencies, and whether abolished oscillations are associated with an adverse outcome in mechanically ventilated patients with sepsis.METHODS: We retrospectively subjected invasive steady-state blood pressure recordings from 65 mechanically ventilated patients with sepsis to spectral analysis. Modified spectral bands were visually identified by plotting spectral power against frequency.RESULTS: Modified middle-frequency and low-frequency (MF' and LF') oscillations were absent in 9% and 22% of the patients, respectively. In patients in whom spontaneous blood pressure oscillations were preserved, the MF' oscillations occurred at 0.021 Hz (median, interquartile range 0.013-0.030), whereas the LF' oscillations occurred at 0.009 Hz (median, interquartile range 0.006-0.010). The absence of LF' oscillations was associated with a higher 30-day mortality [50 vs. 18%, hazard ratio, 3.6 (95% confidence interval: 1.4-9.8), P=0.01].CONCLUSION: Spontaneous blood pressure oscillations in mechanically ventilated septic patients may be suppressed to lower frequencies than previously reported for spontaneously breathing, healthy humans. Patients in whom the resultant changes in blood pressure (MF' and LF' oscillations) are abolished may have a higher risk of an adverse outcome. This may reflect suppression of the pressor area in the brainstem with subsequent sympathetic dysfunction.
KW - Aged
KW - Biological Clocks
KW - Blood Pressure
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Respiration, Artificial
KW - Retrospective Studies
KW - Sepsis
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1097/MBP.0000000000000163
DO - 10.1097/MBP.0000000000000163
M3 - Journal article
C2 - 26544524
VL - 21
SP - 75
EP - 79
JO - Blood Pressure Monitoring
JF - Blood Pressure Monitoring
SN - 1359-5237
IS - 2
ER -
ID: 171554339