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首页> 外文期刊>Surgical Endoscopy >Power spectral analysis of heart rate variability during helium pneumoperitoneum: The mechanism of increased cardiac sympathetic activity and its clinical significance.
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Power spectral analysis of heart rate variability during helium pneumoperitoneum: The mechanism of increased cardiac sympathetic activity and its clinical significance.

机译:氦气腹中心率变异性的功率谱分析:心脏交感神经活动增加的机制及其临床意义。

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BACKGROUND: Carbon dioxide pneumoperitoneum (PP) is known to induce increased cardiac sympathetic expression. The role of the insufflated gas involved in this mechanism should be elucidated in an attempt to eliminate its possible serious consequences. METHODS: Twenty-five patients undergoing elective laparoscopic cholecystectomy were prospectively analyzed for cardiac autonomic nervous activity by spectral heart rate variability. In 15 patients, helium was used as CO(2) substitution for abdominal insufflation (study group). Four frequency bands of interest were obtained from the power spectrum of R-R intervals, as well as the ratio between the low and high frequency (LF/HF), using the fast Fourier transformation algorithm to characterize the synergy of both autonomic branches during PP. RESULTS: Significantly increased values of the power spectrum related to the LF and VLF bands (from 130 to 377 msec(2)/Hz and from 145 to 516 msec(2)/Hz, respectively) were inspected during CO(2) PP, as well as increased LF/LH ratio (2.1). Using helium as CO(2) substitution has eliminated the significant changes in the power spectrum that reflect increased cardiac sympathetic activity. CONCLUSIONS: The elimination of sympathetic predominance by helium PP indicates the central role of CO(2) in establishing this phenomena. Considering this information and its other known advantages, helium should be considered for use during prolonged laparoscopic procedures for high-risk patients.
机译:背景:已知二氧化碳气腹(PP)会诱导心脏交感神经表达的增加。应阐明这种机制中所含气体的作用,以消除其可能的严重后果。方法:前瞻性分析了25例行腹腔镜胆囊切除术的患者的自主神经活动。在15例患者中,氦气被用作腹腔吹入的CO(2)替代品(研究组)。使用快速傅里叶变换算法表征PP期间两个自主分支的协同作用,从R-R间隔的功率谱以及低频与高频之间的比率(LF / HF)获得了四个感兴趣的频带。结果:在CO(2)PP期间,检查了与LF和VLF频段相关的功率谱的显着增加值(分别从130到377 msec(2)/ Hz和145到516 msec(2)/ Hz),以及增加的LF / LH比(2.1)。使用氦气作为CO(2)替代物消除了反映心脏交感神经活动增加的功率谱的重大变化。结论:氦气PP消除了交感神经主导,表明了CO(2)在建立这种现象中的核心作用。考虑到该信息及其其他已知的优势,对于高危患者,应考虑在长期腹腔镜手术期间使用氦气。

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