Development of Algorithms to Predict Hemodynamic Instability

Study Overview
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Brief Summary
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Hemodynamic monitoring in hospitalized patients is crucial since in clinical practice unexpected deterioration of cardiovascular function remains a serious problem and an important cause of death. Novel perspectives in reflex testing of the autonomic nervous system might be useful to protect some patients from cardiovascular events by detecting cardiovascular deteriorations. In addition, standard pulse oximetry in low acuity settings is nowadays predominately used to monitor peripheral oxygen saturation. Of note, there is evidence that additional analyses of pulse wave characteristics might be a valuable source of information to generate additional insights into the cardiorespiratory status of the patient. Herein, we aim to develop novel algorithms in order to protect in-hospital patients from cardiovascular events in consequence of hemodynamic instability in the future.

Detailed Description
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70 datasets from hospitalized patients will be acquired in order to characterize the functional status of the autonomic nervous system as well as hemodynamics during baseline and during standard procedures including physical exercise testing and head-up tilt table testing. Autonomic reflex testing: Heart Rate Characteristics Heart Rate Variability Heart Rate Turbulence Blood Pressure Variability Baroreflex Sensitivity Hyperoxic Chemoreflex Sensitivity Hemodynamic Monitoring: Heart Rate Trends Blood Pressure Trends Pulse Wave Characteristics Cardiac Output Peripheral Vascular Resistance Context information

Official Title
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Development of Algorithms to Detect and Predict Hemodynamic Instability in Patients at Risk

Conditions
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Sudden Cardiac Death

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: hospitalization Age > 17 years Exclusion Criteria: documented diseases of the central nervous system impairment of mental health age > 85 years

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Risk Population<br>Patients being suspected to be at risk of hemodynamic instability due to medical history | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Autonomic Dysfunction | Dysfunction of the autonomic nervous system as assessed by autonomic reflex testing | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hemodynamic Deterioration | Acute hemodynamic changes (Blood pressure changes > 10 mm Hg, heart rate changes > 5 bpm both within 30 seconds) of a patient as assessed by hemodynamic monitoring | 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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autonomic nervous system