Circadian heart rate and blood pressure variability in intensive care unit patients

2013 ◽  
Vol 45 (2) ◽  
pp. 285-292 ◽  
Author(s):  
Taheni Ben Lazreg ◽  
Ilhem Ben Charfeddine ◽  
Ons Mammai ◽  
Abdelbacet Amara ◽  
Oualid Naiija ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Blood Pressure Variability

scholarly journals Efficacy of Diltiazem for the Control of Blood Pressure in Puerperal Patients with Severe Preeclampsia: A Randomized, Single-Blind, Controlled Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Gilberto Arias-Hernández ◽  
Cruz Vargas-De-León ◽  
Claudia C Calzada-Mendoza ◽  
María Esther Ocharan-Hernández
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Severe Preeclampsia ◽  
Secondary Outcome ◽  
Control Group ◽  
Single Blind

Background. Postpartum preeclampsia is a serious disease related to high blood pressure that occurs commonly within the first six days after delivery. Objective. To evaluate if diltiazem improves blood pressure parameters in early puerperium patients with severe preeclampsia. Methodology. A randomized, single-blind longitudinal clinical trial of 42 puerperal patients with severe preeclampsia was carried out. Patients were randomized into two groups: the experimental group (n = 21) received diltiazem (60 mg) and the control group (n = 21) received nifedipine (10 mg). Both drugs were orally administered every 8 hours. Systolic, diastolic, and mean blood pressures as well as the heart rate were recorded and analyzed (two-way repeated measures ANOVA) at baseline and after 6, 12, 18, 24, 30, 36, 42, and 48 hours. Primary outcome measures were all the aforementioned blood pressure parameters. Secondary outcome measures included the number of hypertension and hypotension episodes along with the length of stay in the intensive care unit. Results. No statistical differences were found between groups (diltiazem vs. nifedipine) regarding basal blood pressure parameters. Interarm differences in blood pressure (systolic, diastolic, and mean) and heart rate were statistically significant between treatment groups from 6 to 48 hours. Patients in the diltiazem group had lower blood pressure levels than patients in the nifedipine group. Significantly, patients who received diltiazem had fewer hypertension and hypotension episodes and stayed fewer days in the intensive care unit than those treated with nifedipine. Conclusions. Diltiazem controlled arterial hypertension in a more effective and uniform manner in patients under study than nifedipine. Patients treated with diltiazem had fewer collateral effects and spent less time in the hospital. This trial is registered with NCT04222855.

scholarly journals Characterization of Dexmedetomidine Dosing and Safety in Neonates and Infants

2015 ◽  
Vol 20 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Lauren M. Estkowski ◽  
Jennifer L. Morris ◽  
Elizabeth A. Sinclair
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Systolic Blood Pressure ◽  
Vital Signs ◽  
Pediatric Intensive Care ◽  
Neonates And Infants ◽  
To Receive

OBJECTIVES: To describe and compare off-label use and cardiovascular (CV) adverse effects of dexmedetomidine in neonates and infants in the pediatric intensive care unit (PICU). METHODS: Patients younger than 12 months with corrected gestational ages of at least 37 weeks who were receiving continuous infusion of dexmedetomidine at a tertiary pediatric referral center between October 2007 and August 2012 were assessed retrospectively. Patients were excluded if dexmedetomidine was used for procedural sedation, postoperative CV surgery, or if postanesthesia infusion weaning orders existed at the time of PICU admission. RESULTS: The median minimum dexmedetomidine dose was similar between infants and neonates at 0.2 mcg/kg/hr (IQR, 0.17–0.3) versus 0.29 mcg/kg/hr (IQR, 0.2–0.31), p = 0.35. The median maximum dose was higher for infants than neonates (0.6 mcg/kg/hr [IQR, 0.4–0.8] vs. 0.4 mcg/kg/hr [IQR, 0.26–0.6], p < 0.01). Additional sedative use was more common in infants than neonates (75/99 [76%] vs. 15/28 [54%], p = 0.02). At least 1 episode of hypotension was noted in 34/127 (27%) patients and was similar between groups. An episode of bradycardia was identified more frequently in infants than neonates (55/99 [56%] vs. 2/28 [7%], p < 0.01). Significant reduction in heart rate and systolic blood pressure was noted when comparing baseline vital signs to lowest heart rate and systolic blood pressure during infusion (p < 0.01). CONCLUSIONS: Dexmedetomidine dose ranges were similar to US Food and Drug Administration–labeled dosages for intensive care unit sedation in adults. More infants than neonates experienced a bradycardia episode, but infants were also more likely to receive higher dosages of dexmedetomidine and additional sedatives.

scholarly journals The Effect of Live Spontaneous Harp Music on Patients in the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ann Marie Chiasson ◽  
Ann Linda Baldwin ◽  
Carrol Mclaughlin ◽  
Paula Cook ◽  
Gulshan Sethi
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Intensive Care ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Rest Period ◽  
Underlying Mechanism ◽  
To Receive

This study was performed to investigate the effect of live, spontaneous harp music on individual patients in an intensive care unit (ICU), either pre- or postoperatively. The purpose was to determine whether this intervention would serve as a relaxation or healing modality, as evidenced by the effect on patient’s pain, heart rate, respiratory rate, blood pressure, oxygen saturation, and heart rate variability. Each consenting patient was randomly assigned to receive either a live 10-minute concert of spontaneous music played by an expert harpist or a 10-minute rest period. Spontaneous harp music significantly decreased patient perception of pain by 27% but did not significantly affect heart rate, respiratory rate, oxygen saturation, blood pressure, or heart rate variability. Trends emerged, although being not statistically significant, that systolic blood pressure increased while heart rate variability decreased. These findings may invoke patient engagement, as opposed to relaxation, as the underlying mechanism of the decrease in the patients’ pain and of the healing benefit that arises from the relationship between healer, healing modality, and patient.

scholarly journals Sodium Valproate versus Continuous Infusion of Haloperidol in Management of Agitated Critically Ill Patients

2019 ◽  
Vol 7 (15) ◽  
pp. 2440-2443
Author(s):  
Ramadan Khalil ◽  
Mohamed Soliman ◽  
Mohamed Omer ◽  
Kamel Abdel Aziz ◽  
Khaled Hussein
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Sedation Score ◽  
Efficacy And Safety ◽  
Qtc Prolongation ◽  
Sedative Drugs

AIM: Describe the efficacy and safety of valproate and haloperidol infusion in controlling agitation in the intensive care unit (ICU). MATERIAL AND METHODS: Prospective study on 100 critically ill patients with agitation in Kasralainy Hospital over the period from May 2016 to June 2017.patients were divided into two groups, each group included 50 patients, 1st group patients received Depakene orally, and 2nd group patients received haloperidol by i.v infusion for 72 h. Richmond agitation sedation score and doses of additional sedative drugs were noted and calculated daily in the first three days. RESULTS: Our study showed that valproate was equal in efficacy in controlling agitation; decreasing the RAAS significantly after 48 h from initiation (2.52 ± 0.61 vs 0.28 ± 0.54 with p < 0.001) for Depakene and (2.6 ± 0.67 vs 0.34 ± 0.48 with p < 0.001) for haloperidol. There was also a decrease in the doses of additional sedative drugs used to control agitation (midazolam & propofol) after 48 h from drug initiation. Both drugs therapy was associated with decrease in heart rate (89 ± 20 vs 86.6 ± 13.6 with p = 0.002 for valproate and 99.8 ± 23.3 vs 91 ± 16.7 with p < 0.001 for haloperidol). They did not affect blood pressure. Haloperidol therapy was associated with significant QTc prolongation. CONCLUSION: Valproate was equal in efficacy as haloperidol infusion in controlling agitation in ICU and decreasing the doses of additional sedative drugs used after 48 h from initiation.

scholarly journals Effects of different doses of dexmedetomidine on heart rate and blood pressure in intensive care unit patients

2015 ◽  
Vol 11 (1) ◽  
pp. 360-366 ◽  
Author(s):  
XIAOYAN ZHANG ◽  
RUILAN WANG ◽  
JIAN LU ◽  
WEI JIN ◽  
YONGBIN QIAN ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Different Doses

Bradycardia and hypotension in mianserin intoxication

2010 ◽  
Vol 29 (10) ◽  
pp. 887-888 ◽  
Author(s):  
Zikret Koseoglu ◽  
Banu Kara ◽  
Salim Satar
Keyword(s):  
Blood Pressure ◽  
Adverse Effect ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Side Effects ◽  
Tricyclic Antidepressants ◽  
Medical Intensive Care Unit ◽  
Cardiac Side Effects ◽  
Medical Intensive Care

Cardiotoxicity is an important adverse effect of tricyclic antidepressants. But cardiac side effects after intoxication with the tetracyclic mianserin are rare. In this paper, we describe a case in which bradycardia and hypotension occured due to mianserin overdose. A 37-year-old woman was admitted to the medical intensive care unit for self-poisoning with 30 tablets of 10 mg mianserin 2 hours before her admission. The patient denied taking any other drugs. Four hours after her admission, bradycardia and hypotension occurred and she began to suffer from giddiness. Atropine and theophylline were given. On the second and third day, her heart rate and blood pressure were normal. Based on this case, we estimate the probability of bradycardia and hypotension in mianserin intoxication and the significance of closely monitoring the patient.

scholarly journals Predicting the Death of Cerebrovascular Patients Admitted to Intensive Care Units

2020 ◽  
Author(s):  
Mohammad Karimi Moridani ◽  
Seyed Kamaledin Setarehdan ◽  
Ali Motie Nasrabadi ◽  
Esmaeil Hajinasrollah
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Intensive Care ◽  
Cerebral Ischemia ◽  
Mortality Prediction ◽  
Ecg Signal ◽  
New Approach ◽  
Prediction Horizon

Abstract Background: This article aimed to explore the mortality prediction of cerebrovascular patients in the intensive care unit (ICU) by examining the important signals associated with these patients during different periods of admission in the intensive care unit, which is considered as one of the new topics in the medical field. Several approaches have been proposed for prediction in this area that each of these methods has been able to predict the mortality somewhat, but many of these techniques require the recording of a large amount of data from the patients, where the recording of all data is not possible in most cases; while this article focuses only on the heart rate variability (HRV) and systolic and diastolic blood pressure.Methods: In this paper, using the information obtained from the electrocardiogram (ECG) signal and blood pressure with the help of vital signal processing methods, how to change these signals during the patient's hospitalization will be initially checked. Then, the mortality prediction in patients with cerebral ischemia is evaluated using the features extracted from the return map generated by the signal of heart rate variability and blood pressure. To implement this paper, 80 recorded data from cerebral ischemic patients admitted to the intensive care unit, including ECG signal recording, systolic and diastolic blood pressure, and other physiological parameters are collected. Time of admission and time of death are labeled in all data.Results: The results indicate that the use of the new approach presented in this article can be compared with other methods or leads to better results. The accuracy, specificity, and sensitivity based on the novel features were, respectively, 97.7, 98.9, and 95.4 for cerebral ischemia disease with a prediction horizon of 0.5-1 hours before death.Conclusion: The perspective of the prediction horizons and the patients' length of stay with a new approach was taken into account in this article. The higher the prediction horizon, the nurses or associates of patients have more time to carry out therapeutic measures. To determine the patient's future status and analysis of the ECG signal and blood pressure, at least 7.8 hours of hospitalization is required, which has had a significant reduction compared with other methods.

scholarly journals An exploratory data quality analysis of time series physiologic signals using a large-scale intensive care unit database

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Ali S Afshar ◽  
Yijun Li ◽  
Zixu Chen ◽  
Yuxuan Chen ◽  
Jae Hun Lee ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Time Series ◽  
Intensive Care ◽  
Data Quality ◽  
Vital Signs ◽  
Data Set ◽  
Mimic Iii

Abstract Physiological data, such as heart rate and blood pressure, are critical to clinical decision-making in the intensive care unit (ICU). Vital signs data, which are available from electronic health records, can be used to diagnose and predict important clinical outcomes; While there have been some reports on the data quality of nurse-verified vital sign data, little has been reported on the data quality of higher frequency time-series vital signs acquired in ICUs, that would enable such predictive modeling. In this study, we assessed the data quality issues, defined as the completeness, accuracy, and timeliness, of minute-by-minute time series vital signs data within the MIMIC-III data set, captured from 16009 patient-ICU stays and corresponding to 9410 unique adult patients. We measured data quality of four time-series vital signs data streams in the MIMIC-III data set: heart rate (HR), respiratory rate (RR), blood oxygen saturation (SpO2), and arterial blood pressure (ABP). Approximately, 30% of patient-ICU stays did not have at least 1 min of data during the time-frame of the ICU stay for HR, RR, and SpO2. The percentage of patient-ICU stays that did not have at least 1 min of ABP data was ∼56%. We observed ∼80% coverage of the total duration of the ICU stay for HR, RR, and SpO2. Finally, only 12.5%%, 9.9%, 7.5%, and 4.4% of ICU lengths of stay had ≥ 99% data available for HR, RR, SpO2, and ABP, respectively, that would meet the three data quality requirements we looked into in this study. Our findings on data completeness, accuracy, and timeliness have important implications for data scientists and informatics researchers who use time series vital signs data to develop predictive models of ICU outcomes.

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