Use of the critical-care pain observation tool and the bispectral index for the detection of pain in brain-injured patients undergoing mechanical ventilation: A STROBE-compliant observational study

Medicine
Kai ShanJianxin Zhou

Abstract

The assessment of pain in patients with brain injury is challenging due to impaired ability to communicate. We aimed to test the reliability and validity of the critical-care pain observation tool (CPOT) and the bispectral index (BIS) for pain detection in critically brain-injured patients.This prospective observational study was conducted in a neurosurgical intensive care unit in a University-Affiliated Hospital. Adult brain-injured patients undergoing mechanical ventilation were enrolled. Nociceptive (endotracheal suctioning) and non-nociceptive (gentle touching) procedures were performed in a random crossover fashion. Before and immediately after the procedure, CPOT was evaluated by 2 residents and 2 chief nurses, and BIS was documented. The ability to self-report pain was also assessed. The inter-observer reliability of CPOT was analyzed. The criterion and discriminant validities of the CPOT and the BIS were tested.During the study, we enrolled 400 brain-injured patients. The ability to self-report pain was maintained in 214 (54%) and 218 (55%) patients during suctioning and gentle touching, respectively. The intraclass correlation coefficients (95% confidence interval) for inter-observer reliability of CPOT ranged from 0.8...Continue Reading

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Citations

Jan 18, 2020·AACN Advanced Critical Care·Céline GélinasKathleen A Puntillo
Nov 5, 2019·Intensive & Critical Care Nursing : the Official Journal of the British Association of Critical Care Nurses·Madalina BoitorCéline Gélinas
Mar 13, 2021·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Hemanshu PrabhakarMani Kalaivani
Apr 15, 2021·Critical Care : the Official Journal of the Critical Care Forum·Céline GélinasDavid L Streiner
Sep 4, 2021·Current Opinion in Critical Care·Dario MassariThomas W L Scheeren

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Methods Mentioned

BETA
sedation

Clinical Trials Mentioned

NCT03368326

Software Mentioned

MedCalc
SPSS
power

Related Concepts

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.

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