Cited by 151Heart Rate Variability and Autonomic ControlSepsis Diagnosis and TreatmentNon-Invasive Vital Sign Monitoring

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Clinical review: A review and analysis of heart rate variability and the diagnosis and prognosis of infection

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Ahmad, Saif, Tejuja, Anjali, Newman, Kimberley D, Zarychanski, Ryan, Seely, Andrew JE·2009·Critical Care

DOI 10.1186/cc8132PMC PMC2811891

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Abstract

Bacterial infection leading to organ failure is the most common cause of death in critically ill patients. Early diagnosis and expeditious treatment is a cornerstone of therapy. Evaluating the systemic host response to infection as a complex system provides novel insights: however, bedside application with clinical value remains wanting. Providing an integrative measure of an altered host response, the patterns and character of heart rate fluctuations measured over intervals-in-time may be analysed with a panel of mathematical techniques that quantify overall fluctuation, spectral composition, scale-free variation, and degree of irregularity or complexity. Using these techniques, heart rate variability (HRV) has been documented to be both altered in the presence of systemic infection, and correlated with its severity. In this review and analysis, we evaluate the use of HRV monitoring to provide early diagnosis of infection, document the prognostic implications of altered HRV in infection, identify current limitations, highlight future research challenges, and propose improvement strategies. Given existing evidence and potential for further technological advances, we believe that longitudinal, individualized, and comprehensive HRV monitoring in critically ill patients at risk for or with existing infection offers a means to harness the clinical potential of this bedside application of complex systems science.

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Authors: Ahmad, S., Tejuja, A., Newman, K. D., Zarychanski, R., & Seely, A. J.
Affiliations: Ottawa Hospital Research Institute (CA)
CancerCare Manitoba (CA)
University of Ottawa (CA)
Corresponding author: Seely, Andrew JE
ORCID: Ahmad, Saif
Zarychanski, Ryan
Seely, Andrew JE
Venue: Critical Care
Publisher: Springer Science and Business Media LLC
Published: 2009
Volume: 13
Issue: 6
Pages: 232
ISSN: 1364-8535 (ISSN-L)
DOI: 10.1186/cc8132
PMC: PMC2811891
OpenAlex: W2112011799
Cited by: 151
References: 68
Citations by year: 2026: 3 · 2025: 6 · 2024: 7 · 2023: 6 · 2022: 12 · 2021: 17 · 2020: 17 · 2019: 11 · 2018: 7 · 2017: 9 · 2016: 11 · 2015: 9 · 2014: 8 · 2013: 11 · 2012: 7
FWCI: 0.85
Type: journal article
Language: en
Open access: gold
doi.org
Locations: Critical Care (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: University of Ottawa
Ottawa Hospital Research Institute
Canadian Institutes of Health Research
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
Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
Keywords: heart rate variability, bacterial infection, sepsis, early infection detection, prognosis, critically ill patients, complex systems science, spectral analysis of HRV, infection severity
MeSH terms: Bacterial Infections, Heart Rate, Humans, Prognosis, Resuscitation, Observer Variation, Critical Illness

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Clinical review: A review and analysis of heart rate variability and the diagnosis and prognosis of infection

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