Variability science in intensive care – how relevant is it 英文参考文献.docVIP

Critical Care December 2004 Vol 8 No 6 van de Borne Commentary Variability science in intensive care – how relevant is it? P van de Borne Department of Cardiology, Erasme Hospital, Brussels, Belgium Correspondence: P van de Borne, pvandebo@ulb.ac.be Published online: 24 September 2004 This article is online at /content/8/6/414 ? 2004 BioMed Central Ltd Critical Care 2004, 8:414-415 (DOI 10.1186/cc2938) Related to Research by Seely et al., see page 513 Abstract The article by Seely et al. in this issue of Critical Care highlights that variability portend prognosis. Numerous parameters interact to modify variability in intensive care. The commentary discusses why variability can nevertheless accurately estimate prognosis and how easily this can be implemented in the critically ill. Keywords heart rate, intensive care, prognosis, variability In this issue of Critical Care, Seely and Macklem [1] present a clear and concise overview of several methodologies used to characterize variability. Why is this report important? First, not only does it provide an opportunity to appreciate the principles of the analytical techniques, but it also gives clues for interpreting the results. Those who are unfamiliar with this field of investigation, as well as those who participated in the early time domain and spectral analysis studies but who were somewhat overwhelmed by the complexity of the more recent and elaborate multifractal and entropy analyses, will signals confound the time and frequency domain analyses. This also applies to power law and entropy techniques. Artifacts, ectopy, or more sustained arrhythmias will markedly affect calculations and must be carefully detected and corrected for. Many of these events are unpredictable, whereas others, such as those induced by various nursing procedures, physiotherapy and catheter flushing, must be postponed during data acquisition if at all possible. This is somewhat less imp