Real-time cardiorespiratory coherence detects antinociception during general anesthesia.

Real-time cardiorespiratory coherence detects antinociception during general anesthesia. Brouse, C., J., Karlen, W., Dumont, G., A., Myers, D., Cooke, E., Stinson, J., Lim, J., & Ansermino, J., M. In Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), volume 2012, pages 3813-6, 1, 2012.

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Heart rate variability (HRV) may provide anesthesiologists with a noninvasive tool for monitoring nociception during general anesthesia. A novel real-time cardiorespiratory coherence (CRC) algorithm has been developed to analyze the strength of linear coupling between heart rate (HR) and respiration. CRC values range from 0 (low coherence, strong nociception) to 1 (high coherence, no nociception). The algorithm uses specially designed filters to operate in real-time, minimizing computational complexity and time delay. In the standard HRV high frequency band of 0.15 - 0.4 Hz, the real-time delay is only 5.25 - 3.25 s. We have assessed the algorithm's response to 60 anesthetic bolus events (a large dose of anesthetics given over a short time; strongly antinociceptive) recorded in 47 pediatric patients receiving general anesthesia. Real-time CRC responded strongly to bolus events, changing by an average of 30%. For comparison, three traditional measures of HRV (LF/HF ratio, SDNN, and RMSSD) responded on average by only 3.8%, 14%, and 3.9%, respectively. Finally, two traditional clinical measures of nociception (HR and blood pressure) responded on average by only 3.9% and 0.91%, respectively. CRC may thus be used as a real-time nociception monitor during general anesthesia.

@inproceedings{
 title = {Real-time cardiorespiratory coherence detects antinociception during general anesthesia.},
 type = {inproceedings},
 year = {2012},
 pages = {3813-6},
 volume = {2012},
 websites = {http://www.ncbi.nlm.nih.gov/pubmed/23366759},
 month = {1},
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 abstract = {Heart rate variability (HRV) may provide anesthesiologists with a noninvasive tool for monitoring nociception during general anesthesia. A novel real-time cardiorespiratory coherence (CRC) algorithm has been developed to analyze the strength of linear coupling between heart rate (HR) and respiration. CRC values range from 0 (low coherence, strong nociception) to 1 (high coherence, no nociception). The algorithm uses specially designed filters to operate in real-time, minimizing computational complexity and time delay. In the standard HRV high frequency band of 0.15 - 0.4 Hz, the real-time delay is only 5.25 - 3.25 s. We have assessed the algorithm's response to 60 anesthetic bolus events (a large dose of anesthetics given over a short time; strongly antinociceptive) recorded in 47 pediatric patients receiving general anesthesia. Real-time CRC responded strongly to bolus events, changing by an average of 30%. For comparison, three traditional measures of HRV (LF/HF ratio, SDNN, and RMSSD) responded on average by only 3.8%, 14%, and 3.9%, respectively. Finally, two traditional clinical measures of nociception (HR and blood pressure) responded on average by only 3.9% and 0.91%, respectively. CRC may thus be used as a real-time nociception monitor during general anesthesia.},
 bibtype = {inproceedings},
 author = {Brouse, Christopher J and Karlen, Walter and Dumont, Guy A and Myers, Dorothy and Cooke, Erin and Stinson, Jonathan and Lim, Joanne and Ansermino, J Mark},
 doi = {10.1109/EMBC.2012.6346798},
 booktitle = {Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)}
}

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