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• W1566753892 abstract "Objective: To evaluate autonomic cardiovascular function in traumatic brain injury (TBI) patients and to assess whether autonomic responses to orthostatic-challenge differ between healthy persons and patients with mild or moderate-severe TBI.Background: After TBI, patients are prone to experiencing cardiovascular instability. Furthermore, TBI-severity may correlate with autonomic dysfunction and thus predict autonomic risk.Methods: In 20 mild-TBI-patients (4-78 months after TBI, 6 women, mean age 33±13 years, GCS-scores 30 min after injury 13-15), 20 moderate-severe-TBI-patients (6-94 months after TBI, 4 women, mean age 33±9 years, GCS-scores 30 min after injury <13), and 20 age-matched healthy persons (6 women, mean age 29±10 years), we monitored respiratory frequency, RR-intervals (RRI) and systolic blood pressure (SBP) at supine rest and upon standing. We determined spectral powers of mainly sympathetic low (LF: 0.040.15Hz) and parasympathetic high (HF: 0.15-0.5Hz) frequency RRI-fluctuations, sympathetically mediated LF-powers of SBP, and RRI-LF/HF-ratios, and calculated normalized LF- and HF-powers of RRI. We calculated statistics by repeated measurement analysis of variance, and correlated autonomic parameters with TBI-severity, i.e. GCS-scores (Spearman rank correlation, significance: p<0.05).Results: While supine, BPsys and nuRRI-LF-powers were higher and RRI-HF-powers were lower in moderate-severe-TBI-patients than in mild-TBI-patients and healthy persons. RRI-LF/HF-ratios were higher in moderate-severe-TBI-patients than in healthy persons. Moreover, nuRRI-LF-powers were higher and nuRRI-HF-powers were lower in mild-TBI-patients than in controls. Upon standing, only healthy persons and mild-TBI-patients increased BPsys and decreased RRI-HF-powers. Only healthy persons increased the sympathetically mediated BPsys-LF-powers. GCS-scores correlated with nuRRI-HF-powers, nuRRI-LF-powers, and RRI-LF/HF-ratios at standing position.Conclusions: While supine, sympathetic activity was increased in TBI-patients. Upon standing, TBI-patients did not adequately augment sympathetic and withdraw parasympathetic cardiovascular activity. The correlation of GCS-scores with autonomic parameters upon standing suggests an increased risk of cardiovascular instability with increasing TBI-severity.Acknowledgement: The study was partially funded by the International-Brain-Research-Foundation, IBRF, Flanders, NJ, USA. Disclosure: Dr. Hilz has received personal compensation for activities with Genzyme and Pfizer Inc. as a speaker and/or consultant. Dr. Jorg has nothing to disclose. Dr. Intravooth has nothing to disclose. Dr. Hosl has nothing to disclose. Dr. Koehn has nothing to disclose." @default.
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• W1566753892 date "2015-04-06" @default.
• W1566753892 modified "2023-10-01" @default.
• W1566753892 title "Active standing reveals subtle cardiac autonomic dysfunction in patients with traumatic brain injury (P1.286)" @default.
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