ABSTRACT

Objective

This study aimed to do a literature review to prove the hypothesis that a change in autonomous nervous system regulation, more precisely a decrease in heart rate variability (HRV), is associated with a worse outcome and could be used as a prognostic factor in children with TBI.

Methods

Databases (Pubmed, World of Science and Scopus) studies were conducted from 1996 to 2017, considering HRV in children with TBI. Seven studies were analyzed.

Results

Patients that became brain dead had a markedly lower LF/HF ratio, with a significant decrease after the first few hours of hospitalization. Patients with a more favorable prognosis had significantly higher LF/HF ratios.

Discussion

The HRV can be useful when determining the severity of neurological damage and a prognostic factor in the evaluation of its recovery. However, to assess the true value of HRV monitoring in children with TBI, a prospective study with identified thresholds for HRV, comparison to the standard methods of assessment and predictions should be made blinded to outcome at admission and then through the clinical course including the post-acute phase of rehabilitation. In the absence of this, any recommendation for its use as a prognostic tool may be premature.

中文翻译：

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心率变异性作为脑外伤患儿预后因素的效用

摘要

目的

这项研究旨在进行文献综述，以证明以下假设：自主神经系统调节的改变，更确切地说是心率变异性（HRV）的降低，与较差的预后相关，并且可以用作患儿的预后因素。 TBI。

方法

数据库（公开，科学世界和Scopus）研究于1996年至2017年进行，考虑了TBI儿童的HRV。分析了七个研究。

结果

死于脑死亡的患者的LF / HF比值明显降低，住院的最初几个小时后LF / HF比值明显降低。预后更佳的患者的LF / HF比值明显更高。

讨论区

当确定神经系统损害的严重程度和评估其恢复的预后因素时，HRV可能有用。但是，为了评估在TBI儿童中进行HRV监测的真实价值，应确定一项确定HRV阈值的前瞻性研究，并与标准的评估方法和预测方法进行比较，以免入院时以及随后的整个临床过程（包括术后） -康复的急性期。在没有这种方法的情况下，将其用作预后工具的任何建议都可能为时过早。