ABSTRACT 71

Abstract

Background and aims: Heart rate variability (HRV) reflects autonomic nervous system function. Aims: We hypothesized that HRV can be used as a follow up parameter during SIRS, sepsis, severe sepsis and septic shock. Methods: Patients admitted to our PICU were prospectively enrolled to the study. Twenty-four hour holter monitorization was performed in all patients on the 0, 3th and 7th days of admission. Ethical approval has been obtained. Children with SIRS, sepsis and severe sepsis have constituted the study group S1, and children with septic shock have constituted the study group S2. Other admissions were accepted as a control group. Results: There were 26 children in S1 group, 19 in S2 and 66 in control group. nHF which is related with parasympathetic activity, was significantly different between study group S1 and Control group (p=0.003), and between S1 and S2(p=0.008), but not different between Control and S2 group (p=0.54). nLF is both related with sympathetic and parasympathetic activity and it was significantly different between study group S1 and Control group (p=0.003), and also different between S1 and S2 (p=0.007), but not different between Control and S2 group (p=0.534). Conclusions: Heart rate variability can be used as a follow up parameter in early stage of sepsis. With clinical progression to septic shock HRV parameters become similar to age and sex matched control group. We hypothesized that, this finding may be associated with steroid usage due to adrenal insufficiency. According to 3th day findings it was shown that HRV parameters return to normal values if sepsis resolves.