Electronic ArticleReal-time sample entropy predicts life-saving interventions after the Boston Marathon bombing☆
Section snippets
Background
Appropriate triage of patients after traumatic injury remains a challenge, especially during mass casualty events, such as the Boston Marathon bombing on April 15, 2013. Despite the large number of victims, not all would be severely injured or require life-saving interventions (LSI). Traditional vital signs may not become altered until compensatory physiologic mechanisms become completely exhausted [1]. Various measures of heart rate variability (HRV) and complexity have been shown to be
Methods
The Massachusetts General Hospital is an academic level 1 trauma center managed by an unchanging dedicated trauma and acute care surgery team. Patients that met criteria for trauma team activation and sustained extensive blast injuries during the Boston Marathon bombing on April 15, 2013, were prospectively enrolled in the study. Bombing patients were enrolled in this study under an existing institutional review board–approved investigation with waiver of informed consent.
After arrival to the
Results
From the large number of patients who presented to our institution immediately after the Boston Marathon bombing, only 10 (n = 10) of the victims met trauma team activation criteria. All trauma team activation patients were admitted due to extensive injuries caused by the explosion. All 10 patients had SDNN and SampEn successfully recorded. Most of the victims were young male individuals (60%) with a mean age of 39.1 years (presenting demographics, Table 1). Despite the relatively stable
Discussion
This report supports the results of previously published studies showing the reproducibility and reliability of heart rate complexity measures in predicting the need of LSIs [1], [4], [6]. Specifically, SampEn predicted LSI and was correlated with ISS in the victims of the Boston Marathon bombing presenting to our institution as trauma team activation patients.
Heart rate variability is generally considered to be a nonspecific indicator of health, mirroring the reaction plasticity of the
References (10)
- et al.
Heart-rate complexity for prediction of prehospital lifesaving interventions in trauma patients
J Trauma
(2008) - et al.
Reduced heart rate variability: an indicator of cardiac uncoupling and diminished physiologic reserve in 1,425 trauma patients
J Trauma
(2006 Jun) - et al.
Development of a rugged handheld device for real-time analysis of heart rate: entropy in critically ill patients
J Spec Oper Med
(2013) - et al.
Prehospital loss of R-to-R interval complexity is associated with mortality in trauma patients
J Trauma
(2007) - et al.
Rapid prediction of trauma patient survival by analysis of heart rate complexity: impact of reducing data set size
Shock
(2009)
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No authors have any conflicts of interest.