穿戴个人防护装备三小时对治疗新冠肺炎患者的医护人员心率变异性的影响
Effects of Three-Hour Wearing Personal Protective Equipment on Heart Rate Variability in Healthcare Workers for the Treatment of COVID-19 Patients.
作者信息
Thi Ngoc Le Han, Xuan Nguyen Kien, Duy Nguyen Toan, Quang La Ho, Thanh Nguyen Xuan, Tien Le Dung, Quoc Pham Huy, Xuan Nguyen Khai, Hoang Nguyen Hiep, Van Pham Viet, Van Pham Cong, Pho Dinh Cong, Nhu Do Binh, Viet Tran Tien, Tien Nguyen Son, Dinh Le Tuan, Cong Luong Thuc
机构信息
Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam.
Department of Military Medical Command and Organization, Vietnam Medical Military University, Hanoi, 10000, Vietnam.
出版信息
Int J Gen Med. 2023 Jun 16;16:2531-2539. doi: 10.2147/IJGM.S413626. eCollection 2023.
BACKGROUND
Personal protective equipment (PPE), an essential shield to protect healthcare workers (HCWs) during the COVID-19 pandemic, has been reported to affect their heart rate variability (HRV).
OBJECTIVE
To investigate the changes of very short-term heart rate variability in HCWs after three hours of wearing PPE to treat COVID-19 patients at different working times and intensities, and related factors.
METHODS
Sixty-five healthy HCWs were enrolled at the Number 2 Infectious Field Hospital (formed by Military Hospital 103), Vietnam. Two-minute 12-lead electrocardiograms were recorded before wearing and after removing PPE.
RESULTS
After three hours of wearing PPE, the mean heart rate of HCWs increased (p = 0.048) meanwhile, the oxygen saturation decreased significantly (p = 0.035). Standard deviation of all normal to normal intervals (SDNN), mean intervals RR (mean NN), and root mean square successive difference (rMSSD) after wearing PPE was also reduced significantly. SDNN, Mean NN, and rMSSD decreased as the working intensity increased (as in mild, moderate, and severe patient departments). In univariate regression analysis, logSDNN, logmean NN and logrMSSD were positively correlated with SpO2 and QT interval (r = 0.14, r = 0.31, r = 0.25; r = 0.39, r = 0.77, r = 0.73, respectively) and were negatively correlated with ambient temperature inside PPE (r = -0.41, r = -0.405, r = -0.25, respectively) while logmean NN and log rMSSD were negatively correlated with diastolic blood pressure (r = -0.43, r = -0.39, respectively). In multivariable regression analysis, logSDNN and logmean NN were negatively correlated to ambient temperature inside PPE (r = -0.34, r = -0.18, respectively).
CONCLUSION
Time-domain heart rate variability decreased after wearing PPE. Time-domain HRV parameters were related to ambient temperature inside PPE, diastolic blood pressure, QT interval, and SpO2.
背景
个人防护装备（PPE）是在新冠疫情期间保护医护人员（HCWs）的重要屏障，据报道它会影响医护人员的心率变异性（HRV）。
目的
研究医护人员在不同工作时间和强度下穿戴PPE治疗新冠患者三小时后极短期心率变异性的变化及相关因素。
方法
在越南第2传染病野战医院（由第103军事医院组建）招募了65名健康医护人员。在穿戴PPE前和摘除后记录两分钟的12导联心电图。
结果
穿戴PPE三小时后，医护人员的平均心率增加（p = 0.048），同时血氧饱和度显著下降（p = 0.035）。穿戴PPE后的所有正常到正常间期的标准差（SDNN）、平均RR间期（平均NN）和逐次差值的均方根（rMSSD）也显著降低。随着工作强度增加（如在轻症、中症和重症患者科室），SDNN、平均NN和rMSSD降低。在单变量回归分析中，logSDNN、log平均NN和logrMSSD与SpO2和QT间期呈正相关（r分别为0.14、0.31、0.25；r分别为0.39、0.77、0.73），与PPE内部环境温度呈负相关（r分别为-0.41、-0.405、-0.25），而log平均NN和log rMSSD与舒张压呈负相关（r分别为-0.43、-0.39）。在多变量回归分析中，logSDNN和log平均NN与PPE内部环境温度呈负相关（r分别为-0.34、-0.18）。
结论
穿戴PPE后时域心率变异性降低。时域HRV参数与PPE内部环境温度、舒张压、QT间期和SpO2有关。
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