Öz

Sepsis, kardiyovasküler, solunum ve termoregülasyon gibi sistemlerde patolojik değişikliklere neden olur. Bu değişiklikler de kalp hızı değişkenliğinde (HRV) alterasyonlara neden olur. Vital bulgularda veya hastalığın klinik sunumunda herhangi bir değişiklik olmasa bile, enfeksiyona bağlı olarak sempatik sinir sistemi aktivasyonu nedeniyle HRV parametreleri değişebilir. Bu sistematik derlemedeki amacımız, literatürü inceleyerek sepsise ilişkin HRV ölçümlerini ve parametrelerini sunmak ve bunların sepsisin şiddetini ve ölüm riskini tahmin etmedeki olası rolünü araştırmaktır.

Veritabanları, Nisan 1996 - Mayıs 2023 tarihleri arasında İngilizce dilinde yayınlanmış sepsis üzerine HRV analizlerini insan çalışmalarını bildiren orijinal araştırma makaleleri için tarandı. Makale araması tamamlandıktan sonra, 79 makale daha ayrıntılı bir değerlendirmeye tabi tutulmak üzere seçildi ve bu makalelerin tam metinleri incelendikten sonra 13 makale kriterlere uygun olarak sınıflandırıldı. Her HRV parametrelerinin ortalama değerleri her çalışmanın örnek büyüklüğüne göre düzeltildi ve genel ortalamalar hesaplandı. İstatistiksel karşılaştırmalar Wilcoxon eşleştirilmiş diziler testi ile yapıldı. Toplam 1453 hastanın yer aldığı dokuz çalışma dahil edildi, ortalama yaş 64,24 yıl ve tüm katılımcıların %53,9’u erkekti. Dahil edilen çalışmaların hepsi zaman, frekans domain analizi gerçekleştirdi ve dört tanesi bu analizlere ek olarak doğrusal olmayan analizler gerçekleştirdi. Dokuz çalışmanın yedisini acil serviste ve ikisini hastanelerin yoğun bakım ünitelerinde gerçekleştirildi. Altı çalışma sağ kalanlar ile hayatını kaybedenler arasındaki parametreleri, üç çalışma ise sepsisin farklı şiddet seviyeleri arasındaki parametreleri karşılaştırdı. SDNN, RMSSD, SDNN, HTI, LFnu, HFnu, LF/HF oranı, SD1, SD2, eğilimsiz dalgalanma analizi (DFA)α1 ve DFAα2, sepsis sonucuyla ilişkili gibi görünmektedir. Bu nedenle, sepsisin erken teşhisi için bu parametrelerin izlenmesinin faydalı olabilir.

Anahtar Kelimeler: Sepsis, kalp atım hızı değişkenliği, zaman tabanlı parametreler, frekans tabanlı parametreler, doğrusal olmayan analizler

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Nasıl atıf yapılır?

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Kazdağlı H, Özel HF. Sepsisin Erken Teşhisi ve Prognoz Tahmininde Hangi Kalp Atım Hızı Analiz Ölçümleri ve Parametreleri Kullanışlı Olabilir? Bir Sistematik Derleme. Turk J Intensive Care. 2025;23(1):1-9. https://doi.org/10.4274/tybd.galenos.2024.50023