Kawase M, Komatsu T, Kondo U, Nishiwaki K, Kimura T, Shimada Y
Department of Anesthesiology, Nagoya University, School of Medicine.
Masui. 1998 Aug;47(8):925-32.
The aim of the present study was to evaluate the effects of hemorrhage on heart rate variability (HRV) and blood pressure variability (BPV) as indicators of autonomic nervous system (ANS) and hypovolemia. We induced hemorrhagic hypovolemia in 7 dogs by removing blood in graded stages (0%, 10%, 20%, 30%, 40% of the estimated blood volume; EBV). HR was unchanged during hemorrhage, while mean BP decreased significantly after 30% EBV hemorrhage. Low frequency component (LF: 0.04-0.15 Hz) of HRV significantly increased after 20% EBV hemorrhage but high frequency component (HF: 0.15-0.4 Hz) of HRV was not altered. LF of BPV increased significantly stepwise after 20% EBV hemorrhage and HF of BPV increased significantly after 30% EBV hemorrhage, showing that both LF and HF of BPV might indicate the degree of hypovolemia. During hemorrhage LF of HRV and BPV increased and HF of HRV was unchanged, indicating the shift of the autonomic balance toward sympathetic dominance. An excellent quantitative correlation between LF of BPV and the degree of hypovolemia was demonstrated during graded hemorrhage, while LF of HRV plateaued at its maximum value at 20% EBV hemorrhage. In conclusion, our study suggests that the spectral analysis of HRV and BPV during graded hemorrhage shows different characteristics in the quantitative evaluation of ANS and hypovolemia.
本研究的目的是评估出血对心率变异性（HRV）和血压变异性（BPV）的影响，将其作为自主神经系统（ANS）和血容量不足的指标。我们通过分阶段放血（估计血容量的0%、10%、20%、30%、40%；预计血容量，EBV）诱导7只犬出现出血性血容量不足。出血期间心率未变，而在放血至预计血容量的30%后平均血压显著下降。在放血至预计血容量的20%后，HRV的低频成分（LF：0.04 - 0.15Hz）显著增加，但HRV的高频成分（HF：0.15 - 0.4Hz）未改变。在放血至预计血容量的20%后，BPV的LF逐步显著增加，在放血至预计血容量的30%后，BPV的HF显著增加，表明BPV的LF和HF均可能指示血容量不足的程度。出血期间，HRV的LF和BPV的LF增加，HRV的HF未变，表明自主神经平衡向交感神经占优势转变。在分级出血期间，BPV的LF与血容量不足程度之间呈现出良好的定量相关性，而HRV的LF在放血至预计血容量的20%时达到最大值并趋于平稳。总之，我们的研究表明，分级出血期间HRV和BPV的频谱分析在ANS和血容量不足的定量评估中显示出不同的特征。
