Abstract：
Heart rate variability (HRV) is a predictor of mortality and morbidity after non-lethal cardiac ischemia, but the relation between preoperatively measured HRV and intra- and postoperative complications is sparsely studied and most recently reviewed in 2007. We, therefore, reviewed the literature regarding HRV as a predictor for intra- and postoperative complications and outcomes. We carried out a systematic review without meta-analysis. A PICO model was set up, and we searched PubMed, EMBASE, and CENTRAL. The screening was done by one author, but all authors performed detailed review of the included studies. We present data from studies on intraoperative and postoperative complications, which were too heterogeneous to warrant formal meta-analysis, and we provide a pragmatic review of HRV indices to facilitate understanding our findings. The review was registered in PROSPERO (CRD42021230641). We screened 2337 records for eligibility. 131 records went on to full-text assessment, 63 were included. In frequency analysis of HRV, low frequency to high frequency ratio could be a predictor for intraoperative hypotension in spinal anesthesia and lower total power could possibly predict intraoperative hypotension under general anesthesia. Detrended fluctuation analysis of HRV is a promising candidate for predicting postoperative atrial fibrillation. This updated review of the relation between preoperative HRV and surgical outcome suggests a clinically relevant role of HRV but calls for high quality studies due to methodological heterogeneity in the current literature. Areas for future research are suggested.
摘要：
心率变异性（HRV）是非致死性心肌缺血后死亡率和发病率的预测因子，但术前测量的HRV与术中和术后并发症之间的关系研究很少，最近一次在2007年进行了综述。我们,因此,回顾了有关HRV作为预测术中和术后并发症和预后的文献。我们进行了系统评价，没有进行荟萃分析。建立了一个PICO模型，我们搜索了PubMed,EMBASE,中央。筛查是由一位作者完成的，但所有作者都对纳入的研究进行了详细的回顾.我们提供了有关术中和术后并发症的研究数据，太异质了，不需要正式的荟萃分析，我们对HRV指数进行了务实的审查，以帮助理解我们的发现。该评论在PROSPERO（CRD42021230641）中注册。我们筛选了2337条符合资格的记录。131条记录继续进行全文评估，包括63个。在HRV的频率分析中，低频与高频比可以预测椎管内麻醉术中低血压，较低的总功率可能预测全身麻醉术中低血压。HRV的去趋势波动分析是预测术后心房颤动的一个有希望的候选者。这项关于术前HRV与手术结果之间关系的最新综述表明HRV具有临床相关作用，但由于当前文献中的方法学异质性，因此需要进行高质量的研究。提出了未来研究的领域。
