ISSN (print) 1726-9806     ISSN (online) 1818-474X
No. 3 (2022), ANESTHESIA AND INTENSIVE CARE IN PEDIATRICS
No. 3 (2022)
ANESTHESIA AND INTENSIVE CARE IN PEDIATRICS

Reaction pattern of the autonomic nervous system to the infusion load in the intensive care in children: a prospective comparative study

Published 29.07.2022
K.V. Budarova
Novosibirsk State Regional Clinical Hospital, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, Russia
https://orcid.org/0000-0002-9265-978X
Aleksey N. Shmakov
Novosibirsk State Medical University, Novosibirsk, Russia
https://orcid.org/0000-0002-6214-3897
N.L. Elizar’eva
Novosibirsk State Medical University, Novosibirsk, Russia
https://orcid.org/0000-0002-0852-0372
V.N. Kokhno
Novosibirsk State Medical University, Novosibirsk, Russia
https://orcid.org/0000-0002-5965-2594
#3 2022
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Keywords

infusion therapy
ICU
nervous system
hemodynamics
pediatric

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1.
Budarova K.V., Shmakov A.N., Elizar’eva N.L., Kokhno V.N. Reaction pattern of the autonomic nervous system to the infusion load in the intensive care in children: a prospective comparative study. Annals of Critical Care. 2022;(3):133-144. doi:10.21320/1818-474X-2022-3-133-144
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Abstract

INTRODUCTION. The leading role in the water and electrolyte balance in critical conditions belongs to infusion therapy. Hemodynamic stabilization is achieved by fluid bolus with risk of hypervolemia. Non-invasive monitoring in ICU is relevant in children. Cardiointervalography is characterized by nosological non-specificity and high sensitivity to neurohumoral changes. The stress index and spectral analysis allow the assessment of therapeutic efficacy. OBJECTIVES. To study the features of the electrophysiological response to the emergency rehydrate volume in children upon admission to the intensive care unit. MATERIALS AND METHODS. A prospective comparative study was conducted with the participation of 172 patients, the age from 0 to 15 years. There were 71 newborns in the first group (21 surgical cases, 50 somatic ones). The second group enrolled children aged 1 to 15 years, in 40 % of all underwent surgical treatment. The characteristic of the electrophysiological response to the hydration was carried out in an intergroup and interstage comparison in different age and nosological groups. DISCUSSION. The autonomic nervous system response to infusion therapy has not been studied in children of different ages. The stress index and frequency analysis reflect the degree of regulatory systems tension and are promising in intensive care monitoring. RESULTS. In newborns with sensory block, it was expressed by tachycardia (p = 0.02); without block — arterial hypotension (p = 0.000) without chronotropic component. The implementation of sympathetic reactions was suppressed in children in the early postoperative period. In children without surgical treatment, the volume of infusion had a sympatholytic effect. CONCLUSIONS. In the early postoperative period, the electrophysiological response in children was limited. Age-related features of reactions to hydration in children with somatic pathology were revealed. In children, infusion therapy contributed to a cardiovascular economical work; in newborns, it was associated with a breakdown in sympathetic adaptation.

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References

  1. Черний В.И. Актуальные аспекты инфузионной терапии. Медицина неотложных состояний. 2015; 3(66): 43–53. [Cherniy V.I. Actual aspects of infusion therapy. Emergency Medicine. 2015; 3(66): 43–53. (In Russ)
  2. Йовенко И.А., Царев А.В., Кузьмова Е.А. и др. Клиническая физиология и клиническая фармакология современной инфузионной терапии циркуляторного шока (обзор литературы). Медицина неотложных состояний. 2018; 5: 52–65. [Yovenko I.A., Tsarev A.V., Kuz’mova Ye.A., et al. Clinical physiology and clinical pharmacology of modern infusion therapy of circulatory shock (literature review). Emergency Medicine. 2018; 5: 52–65. (In Russ)]
  3. Прометной Д.В., Александрович Ю.С., Пшениснов К.В. Перегрузка жидкостью как предиктор летального исхода у детей в критическом состоянии. Общая реаниматология. 2019; 15(1): 12–26. DOI: 10.15360/1813-9779-2019-1-12-26 [Prometnoi D.V., Aleksandrovich Yu.S., Pshenisnov K.V. Fluid overload as a predictor of lethal outcome in critically-ill children. General Reanimatology. 2019; 15(1): 12–26. DOI: 10.15360/1813-9779-2019-1-12-26 (In Russ)]
  4. Aya H.D., Rhodes A., Chis Ster I., et al. Hemodynamic effect of different doses of fluids for a fluid challenge: a quasi-randomized controlled study. Crit. Care Med. 2017; 45(2): 161–8.
  5. Чиркова О.Ю., Хаспекова Н.Б., Чечельницкая С.М., Атаманов В.В. Спектральный анализ ритма сердца в оценке вегетативного статуса у детей. Школа здоровья. 1999; 6(1): 90–101. [Chirkova O.Yu., Khaspekova N.B., Chechel’nitskaya S.M., Atamanov V.V. Spectral analysis of heart rate in assessing the vegetative status in children. Shkola zdorov’ya. 1999; 6(1): 90–101. (In Russ)]
  6. Heart Rate Variability. Standards of measurement, physiological interpretation, and clinical use. Task Force European Society of cardiology and the North American Society of pacing and Electrophysiology. European Heart Journal. 1996; 17(3): 354–
  7. Степанова О.А. Поддержание водно-электролитного баланса у недоношенных с очень низкой и экстремально низкой массой тела. Вестник современной клинической медицины. 2016; 9(2): 85–92. DOI: 10.20969/VSKM.2016.9(2).85-92 [Stepanova O.A. Maintenance of fluid and electrolyte balance in preterm infants with very low and extremely low body weight. Bulletin of Contemporary Clinical Medicine. 2016; 9(2): 85–92. DOI: 10.20969/VSKM.2016.9(2).85-92 (In Russ)]
  8. Александрович Ю. С. Интенсивная терапия новорожденных / Ю.С. Александрович, К.В. Пшениснов. СПб.: Изд-во Н–Л. 2013; 672 с. [Aleksandrovich Yu.S. Intensive care of newborns / Yu.S. Aleksandrovich, K.V. Pshenisnov. St. Petersburg: Publishing house N-L. 2013; 672 p. (In Russ)]
  9. Ледяйкин В.И., Пятаев Н.А. Влияние эпидуральной анальгезии на гемодинамику и маркеры стресса при ортопедических операциях у детей. Общая реаниматология. 2011; 7(3): 27–31. [Ledyaykin V.I., Pyataev N.A. Effect of epidural analgesia on hemodynamics and stress markers during orthopedic surgery in children. General resuscitation. 2011; 7(3): 27–31. (In Russ)]
  10. Заболотский Д.В., Корячкин В.А. Ребенок и регионарная анестезия— зачем? куда? и как? Регионарная анестезия и лечение острой боли. 2016; 10(4): 243–53. DOI: 10.18821/1993-6508-2016-10-4-243-253 [Zabolotskii D.V., Koryachkin V.A. Child and regional anesthesia — What for? Where? And how? Regional Anesthesia and Acute Pain Management. 2016; 10(4): 243–53. DOI: 10.18821/1993-6508-2016-10-4-243-253 (In Russ)]
  11. Sichkar I.Yu., Afukov I.I. Epidural anesthesia in newborns and infants with surgical diseases. Russian Bulletin of Pediatric Surgery, Anesthesiology and Resuscitation. 2015; 5(2): 47–54. (In Russ)
  12. Ражев С.В., Степаненко С.М., Сидоров В.А. и др. Этюды регионарной анестезии у детей. 2001; 192 с. DOI: 10.17816/psaic157 [Razhev S.V., Stepanenko S.M., Sidorov V.A., et al. Etudy of regional anesthesia in children. 2001; 192 p. DOI: 10.17816/psaic157 (In Russ)]
  13. Девайкин Е.В., Свалов А.И. Состояние центральной гемодинамики и вегетативного статуса при спинальной анестезии у детей раннего возраста. Регионарная анестезия и лечение острой боли. 2010; 4(2): 25–31. [Devaykin Ye.V., Svalov A.I. The state of central hemodynamics and vegetative status during spinal anesthesia in young children. Regional Anesthesia and Acute Pain Management. 2010; 4(2): 25–31. (InRuss)]
  14. Хмельницкий И.В., Горбачев В.И., Горбачева С.М. Оценка вариабельности ритма сердца в анестезиологической практике. Вестник анестезиологии и реаниматологии. 2016; 13(1); 53–8. DOI: 10.21292/2078-5658-2016-13-1-53-8 [Khmel’nitskiy I.V., Gorbachev V.I., Gorbacheva S.M. Evaluation of the heart rate rhythm variability in anesthesiological practice. Messenger of anesthesiology and resuscitation. 2016; 13(1); 53–8. DOI: 10.21292/2078-5658-2016-13-1-53-8 (In Russ)]
  15. Гайтон А.К. Медицинская физиология / А.К. Гайтон, Дж. Э. Холл. Пер. с англ.; Под ред. В.И. Кобрина. 2008; 173–94. 1296 с. Гл. 14, 15. [Gayton A.K. Medical physiology. A.K. Gayton, Dzh. E. Kholl. Per. from English; Ed. V.I. Kobrin. 2008; 173–94. 1296 p. Chapter 14, 15. (In Russ)]
  16. Mann H.B., Whitney D.R. On a test of whether one of two random variables is stochastically larger than the other. Annals of Mathematical Statistics. 1947; 18; 50–
  17. Wilcoxon F. Individual Comparisons by Ranking Methods. Biometrics Bulletin 1. 1945; 80–
  18. Узунова А.Н., Назарова М.В. Влияние эрготропной терапии на показатели вариабельности сердечного ритма у детей с церебральной ишемией. Педиатрия. 2015; 94(5); 51–7. [Uzunova A.N., Nazarova M.V. The Ergotropic Therapy Effect On The Heart Rate Variability In Children With Cerebral Ischemia. Pediatrics. 2015; 94(5); 51–7. (In Russ)]
  19. Мамий В.И. Оценка функционального состояния. Вариабельность ритма сердца и вегетативный баланс. СПб; 2003. 40 с. [Mamiy V.I. Assessment of the functional state. Heart rate variability and autonomic balance. SPb., 2003; 40 p. (In Russ)]
  20. Петрова И.Н., Трубачев Е.А., Коваленко Т.В., Ожегов А.М. Особенности адаптации сердечно-сосудистой системы в неонатальном периоде у детей с задержкой внутриутробного развития. Российский вестник перинатологии и педиатрии. 2016; 61(3): 40–45. DOI:21508/1027-4065-2016-61-3-40-45 [Petrova I.N., Trubachev E.A., Kovalenko T.V., Ozhegov A.M. Neonatal cardiovascular system adaptation in babies with intrauterine growth retardation. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2016; 61(3): 40–5. DOI: 10.21508/1027-4065-2016-61-3-40-45 (In Russ)]
  21. Баевский Р.М., Иванов Г.Г., Гаврилушкин А.П. и др. Анализ вариабельности сердечного ритма при использовании различных электрокардиографических систем (часть1) [Bayevskiy R.M., Ivanov G.G., Gavrilushkin A.P., et al. Analysis of heart rate variability using various electrocardiographic systems (Message 1). Bulletin of arrhythmology. 2001; 24: 69–85. (In Russ)]
  22. Суворова Л.В., Вахрушева Е.А., Кузмичев Ю.Г. Особенности сердечного ритма дошкольников в норме и патологии по данным кардиоинтервалографии. Нижегородский медицинский журнал. 2001; 2: 30–35. [Suvorova L.V., Vakhrusheva E.A., Kuzmichev Yu.G. Features of the heart rhythm of preschoolers in normal and pathological conditions according to cardiointervalography. Nizhny Novgorod Medical Journal. 2001; 2: 30–35. (In Russ)]
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