Martynas Gedminas, Lukas Neimanas, Dinas Vaitkaitis, Nedas Jasinskas, Viktoras Šaferis, Kęstutis Stašaitis, Paulius Dobožinskas, Aurimas Mačiukas


Study objective. Heart rate variability (HRV) is an objective, easy-to-obtain parameter that can be used to monitor person’s balance of autonomous nervous system, which in turn decides one’s ability to cope with stress. HRV has been used extensively in professional athletes and the military with the purpose of performance optimisation and burnout prevention. The aim of our study was to investigate the balance of EM residents’ autonomic nervous system, as indicated by fluctuations in day-to-day HRV readings, and the feasibility of short relaxation techniques to increase their stress-resilience.

Methods. We conducted a two-month long prospective cross-over double blinded randomized study. Computer randomization was used to divide the EM residents into intervention (A) and control (B) groups. Controls were instructed to listen to a 12 min. relaxation audio file every morning, while the intervention group was equipped with a 12 min. guided meditation that combined rhythmic breathing and attention focusing techniques. After one month, crossover of the interventions took place.

Results. After pooling pre-shift and post-shift HRV data, we identified differences of statistical significance with post-shift HRV readings being higher (p=0.028, p<0,05). Individual HRV trend analysis showed significant fluctuations in day-to-day HRV readings. We could not identify the impact of short relaxation techniques on the EM residents HRV trends. Conclusion. Our findings suggest the lack of autonomic nervous system balance among EM residents, as indicated by big fluctuations in their day-to-day HRV trends. During the course of the study, the HRV reading fluctuations did not stabilise, indicating the limited use of our selected short relaxation techniques to increase residents’ stress resilience. We also identified paradoxical findings of higher post-shift HRV readings which could true be due to unique population in the setting of EM.

Keyword(s): heart rate variability, burnout, emergency medicine, mindfulness, stress resilience, residency training, human performance optimisation.
DOI: 10.5200/sm-hs.2018.005
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