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심박변이도를 이용한 중환자실 입원 환자의 자율신경계 일중변동성에 대한 예비연구
오주영,조동래,김종인,박재섭,허재석,김재진,라세희,신증수,이보름,박진영,Oh, Jooyoung,Cho, Dongrae,Kim, Jongin,Park, Jaesub,Heo, Jaeseok,Kim, Jae-Jin,Na, Se Hee,Shin, Cheung Soo,Lee, Boreom,Park, Jin Young 대한생물정신의학회 2017 생물정신의학 Vol.24 No.1
Objectives A normal circadian rhythm of autonomic nervous system function stands for the daily change of sympathetic and parasympathetic modulation, which can be measured by heart rate variability (HRV). Generally, patients in the intensive care unit (ICU) are prone to sleep-wake cycle dysregulation, therefore, it may have an influence on the circadian rhythm of autonomic nervous system. This study was designed to interpret possible dysregulation of autonomic nervous system in ICU patients by using HRV. Methods HRV was assessed every 3 hours in 21 ICU patients during a 7-minute period. The statistical differences of HRV features between the morning (AM 6 : 00-PM 12 : 00), and the afternoon (PM 12 : 00-PM 18 : 00) periods were evaluated in time domain and frequency domain. Results Patients showed significantly increased normalized power of low frequencey (nLF), absolute power of low frequencey (LF)/absolute power of high frequencey (HF) in the afternoon period as compared to the morning period. However, normalized power of high frequency (nHF) was significantly decreased in the afternoon period. There was no statistically significant difference between the morning period and the afternoon period in the time domain analysis. Conclusions The increased sympathetic tone in the afternoon period supports possible dysregulation in the circadian rhythm of autonomic nervous system in ICU patients. Future studies can help to interpret the association between autonomic dysregulation and negative outcomes of ICU patients.
임상연구 : 성상신경절 차단이 돌발성 난청의 치료에 미치는 영향
송종욱 ( Jong Wook Song ),심재광 ( Jae Kwang Shim ),문진천 ( Jin Cheon Moon ),안은경 ( Eun Kyoung Ahn ),금창만 ( Chang Man Kum ),윤덕미 ( Duck Mi Yoon ),이원상 ( Won Sang Lee ),신증수 ( Cheung Soo Shin ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.1
Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is defined as a sensorineural hearing loss which develops abruptly without definitive causes. Stellate ganglion block (SGB) has been used as one of the treatment modalities in ISSNHL. However, published data establishing the effect of SGB has been slim. We conducted this study to evaluate the effect of SGB according to the factors that may influence the prognosis of the disease. Methods: We reviewed the records of 343 patients. The control group was managed with medications, and the SGB group was managed with SGB and the same medications. SGB was performed with 5 ml of 1.0% mepivacaine. The pure-tone audiogram was performed after the therapy and Siegel`s criteria was used to define the recovery of hearing. Results: The recovery rate of the SGB group was higher than that of the control group (58.1% vs. 42.1%, P < 0.05). The SGB group had a higher recovery rate than the control group in patients treated within 7 days from the onset of symptoms (66.9% vs. 44.1%, P < 0.05), without diabetes mellitus (58.5% vs. 44.9%, P < 0.05), without dizziness (61.6% vs. 44.6%, P < 0.05), or whose initial hearing loss was between 71 and 90 dB (69.4% vs. 38.9%, P < 0.05). Conclusions: SGB is thought to be a useful therapy for ISSNHL, especially in the patients treated within 7 days, without diabetes mellitus, dizziness, or whose initial hearing loss was severe. (Korean J Anesthesiol 2006; 51: 52~7)