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Autonomic nervous system dysfunction (ANSD) is a significant cause of mortality in tetanus. Currently, diagnosis relies on nonspecific clinical signs. Heart rate variability (HRV) may indicate underlying autonomic nervous system activity and represents a potentially valuable noninvasive tool for ANSD diagnosis in tetanus. HRV was measured from three 5-minute electrocardiogram recordings during a 24-hour period in a cohort of patients with severe tetanus, all receiving mechanical ventilation. HRV measurements from all subjects-five with ANSD (Ablett Grade 4) and four patients without ANSD (Ablett Grade 3)-showed HRV was lower than reported ranges for healthy individuals. Comparing different severities of tetanus, raw data for both time and frequency measurements of HRV were reduced in those with ANSD compared with those without. Differences were statistically significant in all except root mean square SD, indicating HRV may be a valuable tool in ANSD diagnosis.

Original publication

DOI

10.4269/ajtmh.19-0720

Type

Journal article

Journal

The American journal of tropical medicine and hygiene

Publication Date

02/2020

Volume

102

Pages

403 - 407

Addresses

Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.

Keywords

Autonomic Nervous System, Humans, Tetanus, Heart Rate, Adult, Aged, Middle Aged, Female, Male