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J Crit Care. 2011 Oct;26(5):534.e1-534.e8. doi: 10.1016/j.jcrc.2011.01.001. Epub 2011 Mar 3.

Significance of new-onset prolonged sinus tachycardia in a medical intensive care unit: a prospective observational study.

Author information

1
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896 Anyang, Gyeonggi-do, Republic of Korea.
2
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Seoul, Republic of Korea.
3
Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896 Anyang, Gyeonggi-do, Republic of Korea.
4
Department of Nursing, Hallym University Sacred Heart Hospital, 896 Anyang, Gyeonggi-do, Republic of Korea.
5
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 39 Boramae-gil, Seoul, Republic of Korea.
6
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896 Anyang, Gyeonggi-do, Republic of Korea. Electronic address: pulmoks@hallym.or.kr.

Abstract

OBJECTIVE:

Few data are available on sinus tachycardia among medical intensive care unit (ICU) patients. We investigated new critical illnesses related to new-onset prolonged sinus tachycardia (NOPST) and the relationship of NOPST with ICU mortality.

METHODS:

The heart rate (HR) of all enrolled patients was monitored hourly over a 12-month period, and NOPST was defined as sinus tachycardia (>100 beats/min) with an increase in HR of more than 20% from the baseline value lasting longer than 6 hours.

RESULTS:

Among the 522 patients enrolled, the average mean HR was 96.1 ± 18.4 beats/min. Fifty-two (10.0%) patients met the criteria for NOPST; pneumonia, delirium, septic shock, acute respiratory distress syndrome, catheter-related infections, and mechanical ventilator-related problems were related to the occurrence of NOPST. The ICU mortality rate in patients with a NOPST duration of more than 72 hours was higher compared with other patients with NOPST (60.0% vs 18.5%; P = .002). A high daily mean HR rather than NOPST was a significant predictor of ICU mortality (odds ratio, 1.415; 95% confidence interval, 1.177-1.700).

CONCLUSIONS:

Although NOPST was not associated with ICU mortality, it indicates the presence of new critical events in the medical ICU setting.

PMID:
21376521
DOI:
10.1016/j.jcrc.2011.01.001
[Indexed for MEDLINE]

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