ANALYSIS OF HEART-RATE-VARIABILITY - A NONINVASIVE PREDICTOR OF DEATHAND POOR OUTCOME IN PATIENTS WITH SEVERE HEAD-INJURY

Background: Analysis of heart-rate variability (HRV) is a promising ne w technique for noninvasive quantification of autonomic function, We m easured HRV in patients with severe head injury to assess its potentia l as a monitoring tool, Methods: Analysis of HRV was prospectively don e on all intensive care unit patients, Concurrent data on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were collected, Registry data were reviewed to identify patients with severe head inju ry, defined as Head/Neck Abbreviated Injury Scale score greater than o r equal to 4. Mortality, likelihood of discharge to home, ICP, and CPP were compared between patients with abnormal HRV and those without, R esults: Low HRV was associated with increased mortality and decreased rate of discharge to home, Abnormal HRV was associated with episodes o f increased ICP and decreased CPP. Conclusion: Assessment of HRV is a noninvasive method that can be widely used, Abnormal HRV was associate d with poor outcome and altered cerebral perfusion. Monitoring of HRV may improve outcome by allowing earlier detection and treatment of int racranial pathology.