Autonomic Stress Response of Nurse Students in an Objective Structured Clinical Examination (OSCE)

The aim of the present research was to analyze the autonomic stress response of nursing students in a nursing Objective Structured Clinical Evaluation (OSCE). We analyzed, in 41 s-year nursing degree students (20.1 ± 2.3 years), modifications in heart rate variability (HRV) to monitor the autonomic stress response before, during and after the 18 different scenarios of a complete OSCE. Heart rate mean response of nurse students was consistent with an anticipatory anxiety response at the beginning of the OSCE, showing a sympathetic nervous system activation, but HRV parameters show contradictory results. The most stressful OSCE station was the CPR maneuver, the stress response varying according to the station’s demands.

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Abstract P153: Heart Rate And Systolic Hypertension At Early Post-kidney Transplant Period

Hypertension ◽

10.1161/hyp.78.suppl_1.p153 ◽

2021 ◽

Vol 78 (Suppl_1) ◽

Author(s):

Ekamol Tantisattamo ◽

Pornthira Mutirangura ◽

Natchaya Polpichai ◽

Sakditad Saowapa ◽

Natsuki Eguchi

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Kidney Transplant ◽

Systolic Hypertension ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Post Transplant ◽

System Activation ◽

Sympathetic Nervous ◽

Sympathetic Nervous System Activation

Introduction: Sympathetic nervous system activation may be assessed by increased heart rate, which is associated with worsened cardiovascular and renal outcomes in general population. We aim to examine association between heart rate and blood pressure in kidney transplant recipients. Methods: A single center retrospective cohort study examines association of average successive heart rate (ASHR), which was defined as the average heart rate between successive office heart rate, with systolic blood pressure (SBP) and diastolic blood pressure (DBP) at 12-, 24-, 36-, and 48-weeks post-transplant by using multiple linear regression. Association of the ASHR with systolic hypertension (SHTN) and diastolic hypertension (DHTN) defined as SBP ≥130 and DBP ≥80 mmHg, respectively, were tested by multiple logistic regression. Results: Of all 105 kidney transplant recipients, mean age±SD was 54±12 years old and 61% was female. ASHR were 80±9, 79±10, 78±11, 76±11 beats/minutes at 12, 24, 36, and 48 weeks, respectively (p 0.509); therefore, ASHR was categorized into low and high ASHR groups (<80 and ≥80 beats/minute). The corresponding SBP were 136±17, 135±19, 132±16, 133±16 mmHg (p 0.356) and DBP were 80±11, 80±12, 78±11, 71±11 mmHg, respectively (p 0.644). With adjustment for age, gender, body mass index, type of kidney transplant, and induction immunosuppressive medications, at 24-week post-transplant, every 10 beats/minute increase in ASHR was associated with 4.4 mmHg decrease in SBP (β adjusted -0.440; p 0.016; 95%CI -0.796, -0.084) and high ASHR group was associated with 0.32-time lower odds of developing SHTN (OR adjusted 0.324; p 0.022; 95%CI 0.124, 0.852). There was no statistically significant association between ASHR and SBP at other post-transplant periods as well as between ASHR and DBP. Conclusions: Increased or high heart rate is associated with lower SBP or SHTN, but not DBP or DHTN at early post-transplant period. This association in an opposite direction among kidney transplant recipients may indicate different effects of sympathetic nervous system activation on blood pressure. Changes in immunological and non-immunological factors may contribute to the findings at different post-transplant periods.

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