The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index.
Autonomic dysfunction in the ICU patient
Abstract
The sympathetic-parasympathetic balance may be altered in critically ill patients. Assessment of autonomic function provides information concerning prognosis, pathogenesis, and treatment strategies in ICU-relevant disorders. Proven tools are heart rate variability, baroreflex sensitivity, and, with limitations, cardiac chemoreflex sensitivity. New nonlinear methods are being evaluated that may predict risk more precisely in critically ill patients. This article summarizes application of these tools in the ICU. In addition, a model is introduced for investigating the impaired autonomic function in multiple organ dysfunction syndrome and sepsis, integrating extrinsic mechanisms and factors that are intrinsic to the cardiac tissue. By this combined approach, the authors hope to gain insight into the pathogenesis of multiple organ dysfunction syndrome. New pathophysiologic concepts are needed for the development of treatment strategies for this life-threatening disease.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with sepsis and organ failure have depressed vagus nerve activity.
“Cholinergic and anticholinergic drugs are also widely used in intensive care units, where patients with sepsis and organ failure have increased cytokine levels and depressed vagus nerve activity (55,56,(81)(82)(83).”
From Physiology and immunology of the cholinergic antiinflammatory pathway (2007) · cites this paper as [81]
Patients with sepsis and organ failure have increased cytokine levels.
“Cholinergic and anticholinergic drugs are also widely used in intensive care units, where patients with sepsis and organ failure have increased cytokine levels and depressed vagus nerve activity (55,56,(81)(82)(83).”
From Physiology and immunology of the cholinergic antiinflammatory pathway (2007) · cites this paper as [81]
Citations
Cites
Heart rate variability: Standards of measurement, physiological interpretation, and clinical use
Malik, M., Bigger, J. T., Camm, A. J., Kleiger, R. E., Malliani, A., Moss, A. J., & Schwartz, P. J. (1996) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a014868 · Cited by 15,289
Rovere, M. T. L., Bigger, J. T., Marcus, F. I., Mortara, A., & Schwartz, P. J. (1998) · The Lancet · doi:10.1016/s0140-6736(97)11144-8 · Cited by 3,120
Cardiac pacemaking in the sinoatrial node
Irisawa, H., Brown, H. F., & Giles, W. R. (1993) · Physiological Reviews · doi:10.1152/physrev.1993.73.1.197 · Cited by 675
Bigger, J. T., Fleiss, J. L., Steinman, R. C., Rolnitzky, L. M., Schneider, W., & Stein, P. K. (1995) · Circulation · doi:10.1161/01.cir.91.7.1936 · Cited by 443
Uncoupling of biological oscillators
Godin, P. J., & Buchman, T. G. (1996) · Critical Care Medicine · doi:10.1097/00003246-199607000-00008 · Cited by 378
Multiple organ dysfunction syndrome: exploring the paradigm of complex nonlinear systems
Seely, A. J. E., & Christou, N. V. (2000) · Critical Care Medicine · doi:10.1097/00003246-200007000-00003 · Cited by 287
Relation between chemosensitivity and the ventilatory response to exercise in chronic heart failure
Chua, T. P., Clark, A. I., Amadi, A. A., & Coats, A. J. S. (1996) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(95)00523-4 · Cited by 276
Ponikowski, P. P., Chua, T. P., Piepoli, M. F., Ondušová, D., Webb-Peploe, K., Harrington, D., Anker, S. D., Volterrani, M., Colombo, R., MAZZUERO, G., et al. (1997) · Circulation · doi:10.1161/01.cir.96.8.2586 · Cited by 269
GRUNAU, R. E., Oberlander, T. F., Whitfield, M. F., et al. (2001) · PEDIATRICS · doi:10.1542/peds.107.1.105 · Cited by 254
Effects of relaxing music on cardiac autonomic balance and anxiety after acute myocardial infarction
White, J. (1999) · American Journal of Critical Care · doi:10.4037/ajcc1999.8.4.220 · Cited by 245
Experimental human endotoxemia increases cardiac regularity
Godin, P. J., Fleisher, L. A., Eidsath, A. B., Vandivier, R. W., Preas, H. L., Banks, S. M., Buchman, T. G., & Suffredini, A. F. (1996) · Critical Care Medicine · doi:10.1097/00003246-199607000-00009 · Cited by 222
Dysautonomia after traumatic brain injury: a forgotten syndrome?
Baguley, I. J., Nicholls, J., Felmingham, K. L., Crooks, J., Gurka, J. A., & Wade, L. D. (1999) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.67.1.39 · Cited by 213
Chaos Theory, Heart Rate Variability, and Arrhythmic Mortality
Lombardi, F. (2000) · Circulation · doi:10.1161/01.cir.101.1.8 · Cited by 205
Comparison of baroreflex sensitivity and heart period variability after myocardial infarction
Bigger, J. T., Rovere, M. T. L., Steinman, R. C., Fleiss, J. L., Rottman, J. N., Rolnitzky, L. M., & Schwartz, P. J. (1989) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(89)90390-2 · Cited by 181
Pitzalis, M. V., Mastropasqua, F., Passantino, A., Massari, F., Ligurgo, L., Forleo, C., Balducci, C., Lombardi, F., & RIZZON, P. (1998) · Circulation · doi:10.1161/01.cir.97.14.1362 · Cited by 178
Heart rate variability after acute traumatic brain injury in children
Biswas, A. K., Scott, W. A., Sommerauer, J. F., & Luckett, P. M. (2000) · Critical Care Medicine · doi:10.1097/00003246-200012000-00030 · Cited by 173
Extracerebral organ dysfunction and neurologic outcome after aneurysmal subarachnoid hemorrhage
Gruber, A. R., Reinprecht, A., Illievich, U. M., et al. (1999) · Critical Care Medicine · doi:10.1097/00003246-199903000-00026 · Cited by 172
Effect of Combined Sympathetic and Vagal Stimulation on Heart Rate in the Dog
Warner, H. R., & Russell, R. O. (1969) · Circulation Research · doi:10.1161/01.res.24.4.567 · Cited by 153
BEHAVIOR, PAIN PERCEPTION, AND THE EXTREMELY LOW-BIRTH WEIGHT SURVIVOR
Whitfield, M. F., & GRUNAU, R. E. (2000) · Clinics in Perinatology · doi:10.1016/s0095-5108(05)70026-9 · Cited by 141
Chua, T. P., Harrington, D., Ponikowski, P. P., Webb-Peploe, K., Poole-Wilson, P. A., & Coats, A. J. S. (1997) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(96)00446-9 · Cited by 141
Chua, T. P., & Coats, A. J. S. (1995) · European Journal of Clinical Investigation · doi:10.1111/j.1365-2362.1995.tb01962.x · Cited by 82
Power spectral analysis of cardiovascular variability in critically ill neurosurgical patients
Haji-Michael, P. G., Vincent, J., Degaute, J.-P., & van de Borne, P. (2000) · Critical Care Medicine · doi:10.1097/00003246-200007000-00066 · Cited by 82
Maestri, R., Pinna, G. D., Mortara, A., Rovere, M. T. L., & Tavazzi, L. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(97)00499-3 · Cited by 76
Linear and nonlinear analysis of hemodynamic signals during sepsis and septic shock
Toweill, D. L., Sonnenthal, K., Kimberly, B., Lai, S., & Goldstein, B. (2000) · Critical Care Medicine · doi:10.1097/00003246-200006000-00063 · Cited by 73
Müller‐Werdan, U. (1998) · Journal of Molecular and Cellular Cardiology · doi:10.1006/jmcc.1998.0667 · Cited by 71
Self-citationAdvancements in estimating baroreflex function
Rienzo, M. D., Castiglioni, P., Mancia, G., et al. (2001) · IEEE Engineering in Medicine and Biology Magazine · doi:10.1109/51.917721 · Cited by 65
Indicators of dysautonomia in severe Guillain-Barré syndrome
Pfeiffer, G., Schiller, B., Kruse, J., et al. (1999) · Journal of Neurology · doi:10.1007/s004150050506 · Cited by 64
Plasmapheresis combined with continuous venovenous hemofiltration in surgical patients with sepsis
Schmidt, J. L., Mann, S., Mohr, V. D., et al. (2000) · Intensive Care Medicine · doi:10.1007/s001340051200 · Cited by 63
Cardiodepression by tumor necrosis factor-alpha.
Müller‐Werdan, U., Engelmann, H., & Werdan, K. (1998) · PubMed · Cited by 62
Self-citationKučera, J., Heuschkel, M. O., Renaud, P., & Rohr, S. (2000) · Circulation Research · doi:10.1161/01.res.86.11.1140 · Cited by 57
Complexity, chaos, and incomprehensibility: Parsing the biology of critical illness
Marshall, J. C. (2000) · Critical Care Medicine · doi:10.1097/00003246-200007000-00080 · Cited by 42
A mathematical model for autonomic control of heart rate variation
Chiu, H., & Kao, T. (2001) · IEEE Engineering in Medicine and Biology Magazine · doi:10.1109/51.917726 · Cited by 33
Kuo, C., Chen, G.-Y., & Lo, H. (2000) · Critical Care Medicine · doi:10.1097/00003246-200005000-00004 · Cited by 32
Hennersdorf, M., Perings, C., Niebch, V., et al. (2000) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2000.tb00827.x · Cited by 28
Müller‐Werdan, U., & Werdan, K. (1999) · Current Opinion in Critical Care · doi:10.1097/00075198-199910000-00013 · Cited by 26
Self-citationValidating phase relations between cardiac and breathing cycles during sleep
Hoyer, D., Frasch, M. G., Eiselt, M., Hoyer, O., & Zwiener, U. (2001) · IEEE Engineering in Medicine and Biology Magazine · doi:10.1109/51.917730 · Cited by 21
The use of clonidine in the management of autonomic overactivity in neuroleptic malignant syndrome
Gregorakos, L., Thomaides, T. N., Stratouli, S., et al. (2000) · Clinical Autonomic Research · doi:10.1007/bf02291355 · Cited by 17
An optimal control model of 1/f fluctuations in heart rate variability
Nakao, M., Takizawa, T., Nakamura, K., et al. (2001) · IEEE Engineering in Medicine and Biology Magazine · doi:10.1109/51.917727 · Cited by 15
Flachenecker, P., & Reiners, K. (1999) · Journal of the Neurological Sciences · doi:10.1016/s0022-510x(99)00096-9 · Cited by 14
Schmidt, H. B., Rauchhaus, M., Francis, D. P., Davies, C., Nuding, S., Peschel, T., Schmidt, D. S., Coats, A. J. S., Opitz, H., & Werdan, K. (2001) · International Journal of Cardiology · doi:10.1016/s0167-5273(01)00377-1 · Cited by 13
Self-citationSevere cardiovascular autonomic dysfunction in a patient with Guillain-Barre syndrome: a case report
Zöllei, É., Avramov, K., Gingl, Z., et al. (2000) · Autonomic Neuroscience · doi:10.1016/s1566-0702(00)00188-0 · Cited by 11
Ghosh, I. R., Langford, R. M., Nieminen, K., et al. (2000) · British Journal of Anaesthesia · doi:10.1093/bja/85.3.471 · Cited by 9
Flagged first, then by citations
Research works printed but not linked: 1
- M??ller-Werdan, 1998, Eur Cytokine Netw, 9, 689
Cited by
Sorted by citations
Physiology and immunology of the cholinergic antiinflammatory pathway
Tracey, K. J. (2007) · Journal of Clinical Investigation · doi:10.1172/jci30555 · Cited by 1,563
Ahmad, S., Tejuja, A., Newman, K. D., Zarychanski, R., & Seely, A. J. (2009) · Critical Care · doi:10.1186/cc8132 · Cited by 151
Metadata
- Authors
- Schmidt, H. B., Werdan, K., & Müller-Werdan, U.
- Affiliations
- Martin Luther University Halle-Wittenberg (DE)
- Corresponding author
- Werdan, Karl
- ORCID
- Werdan, Karl
- Venue
- Current Opinion in Critical Care
- Published
- 2001-10
- Volume
- 7
- Issue
- 5
- Pages
- 314-322
- ISSN
- 1070-5295 (ISSN-L)
- OpenAlex
- W2018366225
- Cited by
- 138
- References
- 42
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 4 · 2019: 5 · 2018: 7 · 2017: 4 · 2016: 3 · 2015: 6 · 2014: 6 · 2013: 7 · 2012: 10
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Critical Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- autonomic dysfunction, critically ill patients, heart rate variability, baroreflex sensitivity, nonlinear methods, multiple organ failure, sepsis, sympathetic and parasympathetic balance, prognosis
- MeSH terms
- Autonomic Nervous System, Autonomic Nervous System Diseases, Cardiovascular System, Heart Rate, Humans, Intensive Care Units, Multiple Organ Failure, Respiratory System, Critical Illness, Baroreflex
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review