Decreased physiologic variability as a generalized response to human endotoxemia

Crit Care Med. 2005 Mar;33(3):512-9. doi: 10.1097/01.ccm.0000155908.46346.ed.

Abstract

Objective: To test the effect in normal human volunteers of transient systemic inflammation on the variability in time-series behaviors of widely divergent physiologic measures of the human inflammatory response.

Design: Prospective study of human volunteers who were tested on 2 consecutive days, a control day and a treatment day. Each participant served as his or her own control.

Setting: Critical care facility of a university medical center.

Subjects: Subjects were eight healthy human volunteers.

Interventions: Participant subjects were tested on both a baseline day with no intervention and on a treatment day when they received 4 ng/kg intravenous Escherichia coli endotoxin.

Measurements and main results: Continuous electrocardiographic recordings and serial blood sampling (performed every 5 mins) were used to create time-series of heart rate (R-R intervals), neutrophil function (phagocytosis), and plasma cortisol concentrations. For each primary measure, we recorded a significant increase in the regularity (decreased variability) of the functional measurement as assessed by the statistical entity, approximate entropy.

Conclusions: Increased regularity, or decreased variability, of organ functions is a generalized response to systemic inflammation that occurs in widely divergent systems during endotoxemia.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Biological Clocks*
  • Endotoxemia / physiopathology
  • Entropy
  • Female
  • Heart Rate
  • Humans
  • Hydrocortisone / blood
  • Inflammation / physiopathology*
  • Male
  • Middle Aged
  • Neutrophils / metabolism
  • Nonlinear Dynamics
  • Phagocytosis
  • Prospective Studies
  • Sepsis / physiopathology*

Substances

  • Hydrocortisone