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A Preliminary Study on the Circadian Rhythm of Autonomic Nervous System in Patients Admitted to Intensive Care Unit, Using the Heart Rate Variability  

Oh, Jooyoung (Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology)
Cho, Dongrae (Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology)
Kim, Jongin (Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology)
Park, Jaesub (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
Heo, Jaeseok (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
Kim, Jae-Jin (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
Na, Se Hee (Department of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine)
Shin, Cheung Soo (Department of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine)
Lee, Boreom (Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology)
Park, Jin Young (Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine)
Publication Information
Korean Journal of Biological Psychiatry / v.24, no.1, 2017 , pp. 26-31 More about this Journal
Abstract
Objectives A normal circadian rhythm of autonomic nervous system function stands for the daily change of sympathetic and parasympathetic modulation, which can be measured by heart rate variability (HRV). Generally, patients in the intensive care unit (ICU) are prone to sleep-wake cycle dysregulation, therefore, it may have an influence on the circadian rhythm of autonomic nervous system. This study was designed to interpret possible dysregulation of autonomic nervous system in ICU patients by using HRV. Methods HRV was assessed every 3 hours in 21 ICU patients during a 7-minute period. The statistical differences of HRV features between the morning (AM 6 : 00-PM 12 : 00), and the afternoon (PM 12 : 00-PM 18 : 00) periods were evaluated in time domain and frequency domain. Results Patients showed significantly increased normalized power of low frequencey (nLF), absolute power of low frequencey (LF)/absolute power of high frequencey (HF) in the afternoon period as compared to the morning period. However, normalized power of high frequency (nHF) was significantly decreased in the afternoon period. There was no statistically significant difference between the morning period and the afternoon period in the time domain analysis. Conclusions The increased sympathetic tone in the afternoon period supports possible dysregulation in the circadian rhythm of autonomic nervous system in ICU patients. Future studies can help to interpret the association between autonomic dysregulation and negative outcomes of ICU patients.
Keywords
Heart rate variability; Circadian rhythm; Autonomic nervous system; Intensive care unit;
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