Cardiovascular Variability and Control in Early Sepsis

早期脓毒症的心血管变异和控制

基本信息

批准号：
8728940
负责人：
Samuel Morris Brown
金额：
$ 12.1万
依托单位：
IHC HEALTH SERVICES, INC.
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-16 至 2015-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8728940
关键词：
Address Admission activity Albumins Area Blood Pressure Breathing Cardiovascular system Clinical Colloids Complex Computerized Medical Record Critical Illness Data Data Set Databases Early Intervention Early treatment Entropy Foundations Fractals Genetic Healthcare Heart Rate Homeostasis Hour IV Fluid Individual Infection Intervention Intravenous infusion procedures Investigation Knowledge Life Measures Mechanical ventilation Outcome Patient Care Patients Pattern Pharmaceutical Preparations Phase Physiological Predictive Value Pulse Pressure Records Recovery Research Resuscitation Risk Saline Sampling Scientist Sepsis Septic Shock Series Severities Staging Syndrome System Techniques Therapeutic Intervention Time Variant Vasoconstrictor Agents Ventilator Work base career cohort crystalloid heart rate variability high risk improved insight mortality novel predictive modeling primary outcome response restoration secondary outcome septic signal processing

项目摘要

DESCRIPTION (provided by applicant): Sepsis is a common, complex, life-threatening syndrome arising from serious infection. Early, tailored therapy is crucial to the outcome of sepsis, but reliable endpoints for therapy have proved elusive. This lack of reliable Statistical and signal-processing analyses of variability in the body's cardiovascular control system may prove useful in defining valid endpoints for early therapy of sepsis, as well as identifying patients at high risk for poor outcome from sepsis. Employing the highly detailed electronic medical record at Intermountain Healthcare, this proposal aims to study patterns in the variability of heart rate and arterial blood pressure in a large cohort of patients with severe sepsis and septic shock. This research hypothesizes that spectral and non-linear measures of cardiovascular variability like spectral power, sample entropy, and fractal exponents will predict recovery of cardiovascular homeostasis by 24 hours after presentation in septic patients. This research further hypothesizes that changes in cardiovascular variability in response to early therapies will improve our ability to predict recovery of cardiovascular homeostasis. Finally, this research hypothesizes that patterns in variability will predict immediate response to administration of vasopressor drugs or intravenous fluids. This research intends to lay the groundwork for improved bedside care of patients with sepsis as well as better understanding of mechanisms of disruption and restoration of homeostasis in patients with sepsis.

描述（由申请人提供）：败血症是由严重感染引起的常见，复杂的威胁生命的综合征。早期的，量身定制的疗法对于败血症的结果至关重要，但可靠的治疗终点被证明是难以捉摸的。缺乏可靠的统计和信号处理分析的人体心血管控制系统可变性的分析可能被证明可用于确定败血症的早期治疗的有效终点，并确定败血症结果较差的患者的高风险。该提案在Intermountain Healthcare上采用高度详细的电子病历，旨在研究大量严重败血症和败血性休克患者的心率和动脉血压变化的模式。这项研究假设，谱系频谱变异性（如光谱功率，样品熵和分形指数）的光谱和非线性度量将预测化粪池患者24小时后心血管稳态的恢复。这项研究进一步假设，响应早期疗法的心血管变异性的变化将提高我们预测心血管稳态恢复的能力。最后，这项研究假设可变性的模式将预测对加压药药物或静脉液体的给药的立即反应。这项研究旨在为改善败血症患者的床旁护理奠定基础，并更好地理解败血症患者的破坏和恢复体内平衡的机制。

项目成果

期刊论文数量（27）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Long-term outcomes after severe shock.

严重休克后的长期结果。

DOI：
10.1097/shk.0000000000000283
发表时间：
2015
期刊：
Shock (Augusta, Ga.)
影响因子：
0
作者：
Pratt,CristinaM;Hirshberg,EliotteL;Jones,JasonP;Kuttler,KathrynG;Lanspa,MichaelJ;Wilson,EmilyL;Hopkins,RamonaO;Brown,SamuelM
通讯作者：
Brown,SamuelM

Defining severe pneumonia.

DOI：
10.1016/j.ccm.2011.05.001
发表时间：
2011-09
期刊：
Clinics in chest medicine
影响因子：
5.7
作者：
Brown SM;Dean NC
通讯作者：
Dean NC

Horses and Zebras: complex cardiac anatomy in a patient with out-of-hospital cardiac arrest.

马和斑马：院外心脏骤停患者的复杂心脏解剖结构。

DOI：
10.1007/s13089-011-0059-2
发表时间：
2011
期刊：
Critical ultrasound journal
影响因子：
0
作者：
Brown,SamuelM;Miller,DylanV;Vezina,Daniel;Dean,NathanC;Grissom,ColinK
通讯作者：
Grissom,ColinK

A modified sequential organ failure assessment score for critical care triage.

DOI：
10.1001/dmp.2010.40
发表时间：
2010-12
期刊：
DISASTER MEDICINE AND PUBLIC HEALTH PREPAREDNESS
影响因子：
2.7
作者：
Grissom, Colin K.;Brown, Samuel M.;Kuttler, Kathryn G.;Boltax, Jonathan P.;Jones, Jason;Jephson, Al R.;Orme, James F., Jr.
通讯作者：
Orme, James F., Jr.

Do heart and respiratory rate variability improve prediction of extubation outcomes in critically ill patients?

DOI：
10.1186/cc13822
发表时间：
2014-04-08
期刊：
Critical care (London, England)
影响因子：
0
作者：
Seely AJ;Bravi A;Herry C;Green G;Longtin A;Ramsay T;Fergusson D;McIntyre L;Kubelik D;Maziak DE;Ferguson N;Brown SM;Mehta S;Martin C;Rubenfeld G;Jacono FJ;Clifford G;Fazekas A;Marshall J;Canadian Critical Care Trials Group (CCCTG)
通讯作者：
Canadian Critical Care Trials Group (CCCTG)