Spectral and fractal analysis of cardiointerval variation in determining the functional state of the autonomic nervous system in postpartum women with multiple organisystem dysfunction failure syndrome

Aim. To examine the functional state of the autonomic nervous system (ANS) in postpartum women with multiple organ/system dysfunction/failure syndrome, depending on the dominant organ damage using non-invasive monitoring of cardiointerval variation.

Material and methods. The study included 100 postpartum women with multiple organ/system dysfunction/failure syndrome (MOSDFS). They were divided into four groups: Group 1 (40 patients) with predominant acute kidney injury; Group 2 (30 patients) with primary manifestations of acute liver failure; Group 3 (30 patients) with dominant acute respiratory distress syndrome; and the control group (30 healthy women of reproductive age). All patients had MOSDFS, with one dysfunction being predominant and the others at various stages and degrees of severity (80% with three affected organs and 20% with two organs). Dysfunction of the central nervous system (CNS) and its autonomic divisions were observed in all cases. An assessment of spectral and fractal analyses was conducted along with an evaluationof the degree of integration of systemic connections forming extracardiac regulation of heart rhythm by the CNS. Additionally, heart rate variability and the state of autonomic balance were also analyzed.

Results and discussion. Non-invasive RR-interval monitoring in the studied postpartum women revealed significant dysfunction of the CNS and ANS in a form of imbalances and various zones of functional states across all groups, regardless of the predominant organ damage and subsequent functional failure. These disruptions manifested.

Conclusion. Among five conditional zones of autonomic states (stable autonomic balance, adaptation, subcritical, critical, and supercritical), 45% of postpartum women were in the critical zone and 55% in the supercritical zone. This necessitates a personalized approach to diagnosis and treatment.

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