Izvorni znanstveni članak
https://doi.org/10.22514/SV132.112017.5
Heart rate variability analysis in acute poisoning by cholinesterase inhibitors
JINWOO JEONG
; Department of Emergency Medicine, Dong-A University Hospital,Seogu, Busan, Republic of Korea
YONGIN KIM
Sažetak
Heart rate variability (HRV) has been associated
with a variety of clinical situations.
However, few studies have examined the
association between HRV and acute poisoning.
Organophosphate (OP) and carbamate
inhibit esterase enzymes, particularly
acetylcholinesterase, resulting in an
accumulation of acetylcholine and thereby
promoting excessive activation of corresponding
receptors. Because diagnosis and
treatment of OP and carbamate poisoning
greatly depend on the severity of cholinergic
symptoms, and because HRV reflects
autonomic status, some HRV parameters
may be of value in diagnosing OP and carbamate
poisoning among patients visiting
the emergency department.
Patients who visited the emergency department
of the study hospital between
September 2008 and May 2010 with the
chief complaint of acute poisoning or overdose
were included. Cases that involved
ingestion of OP or carbamate insecticides
were classified as poisoning by cholinesterase
inhibitors and compared with other
cases of poisoning or overdose. The timedomain
analysis included descriptive statistics
of R-R intervals and instantaneous
heart rates. The frequency-domain analysis
used fast Fourier transformation. A
Poincaré plot, which is a scatterplot of R-R
intervals against the preceding R-R interval,
was used for the nonlinear analysis.
Very-low-frequency (VLF) power and the
ratio of low-frequency-to-high-frequency
power (LF/HF) were the most effective parameters
for distinguishing cholinesterase
inhibitor poisoning among cases of acute
poisoning, with areas under the receiveroperating
characteristic curve of 0.76 and
0.87, respectively. Cholinesterase inhibitor
poisoning was a significant factor determining
VLF power and the LF/HF ratio
after adjusting for possible confounding
variables, including age over 40, gender,
and tracheal intubation.
Frequency-domain parameters of HRV,
such as VLF power and the LF/HF ratio,
might be considered as potential diagnostic
methods to distinguish cholinesterase
inhibitor poisoning from other cases of intoxication
in the early stages of emergency
care.
Ključne riječi
electrocardiography; organophosphates; carbamates; poisoning
Hrčak ID:
190591
URI
Datum izdavanja:
12.12.2017.
Posjeta: 836 *