Determination of Psychometric Properties of Non-Verbal Pain Scale in Patients Receiving Mechanical Ventilation

Background: This study aimed to determine the effectiveness of music listening for procedural pain relief using two different observational pain tools during endotracheal suctioning. Materials and Methods: This study was a randomized controlled trial. The sample of the study included 98 patients with mechanical ventilation support who met the selection criteria. The patients were randomly assigned to control and music therapy groups. Patients in the control group were routinely suctioned as usual. Patients in the music group received music therapy 20 min before, during, and 20 min after endotracheal suctioning. The primary outcome was the pain relief during suctioning. Results: Forty patients in each arm completed the study. Pain scores in the Critical Care Pain Observation Tool and Behavioral Pain Scale were lower in the music group than in the control group during endotracheal suctioning (group: F = 14.85, p = 0.000; F = 9.04, p = 0.000, respectively). It was also found to be a significant interaction effect between the groups and time (group × time: F = 17.35, p = 0.000; F = 18.00, p = 0.000, respectively). Conclusion: The Critical Care Pain Observation Tool and Behavioral Pain Scale in the current study generally demonstrated similar pain scores during the painful procedure. Our findings support that music therapy may act as a nonpharmacological therapy to relieve procedural pain in patients on mechanical ventilation.

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A Systematic Review of the Psychometric Properties of the Modified Behavioral Pain Scale (MBPS)

Journal of Pediatric Nursing ◽

10.1016/j.pedn.2018.02.005 ◽

2018 ◽

Vol 40 ◽

pp. 14-26 ◽

Cited By ~ 2

Author(s):

Dianne J. Crellin ◽

Franz E. Babl ◽

Nick Santamaria ◽

Denise Harrison

Keyword(s):

Systematic Review ◽

Psychometric Properties ◽

Pain Scale ◽

Behavioral Pain Scale

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Evaluation of Pain Assessment Tools in Patients Receiving Mechanical Ventilation

AACN Advanced Critical Care ◽

10.4037/aacnacc2016287 ◽

2016 ◽

Vol 27 (2) ◽

pp. 162-172 ◽

Cited By ~ 11

Author(s):

Zainab Q. Al Darwish ◽

Radwa Hamdi ◽

Summayah Fallatah

Keyword(s):

Mechanical Ventilation ◽

Intensive Care ◽

Pain Assessment ◽

Descriptive Study ◽

Pain Scale ◽

Assessment Tools ◽

Highly Sensitive ◽

Sensitive Tool ◽

P 16 ◽

Behavioral Pain Scale

Pain assessment poses a great challenge for clinicians in intensive care units. This descriptive study aimed to find the most reliable, sensitive, and valid tool for assessing pain. The researcher and a nurse simultaneously assessed 47 nonverbal patients receiving mechanical ventilation in the intensive care unit by using 3 tools: the Behavioral Pain Scale (BPS), the Critical-Care Pain Observation Tool (CPOT), and the adult Nonverbal Pain Scale (NVPS) before, during, and after turning and suctioning. All tools were found to be reliable and valid (Cronbach α = 0.95 for both the BPS and the CPOT, α = 0.86 for the NVPS), and all subscales of both the BPS and CPOT were highly sensitive for assessing pain (P < .001). The NVPS physiology (P = .21) and respiratory (P = .16) subscales were not sensitive for assessing pain. The BPS was the most reliable, valid, and sensitive tool, with the CPOT considered an appropriate alternative tool for assessing pain. The NVPS is not recommended because of its inconsistent psychometric properties.

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Tuberculosis in the Intensive Care Unit: A Retrospective Descriptive Cohort Study with Determination of a Predictive Fatality Score

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2012/361292 ◽

2012 ◽

Vol 23 (4) ◽

pp. 173-178 ◽

Cited By ~ 14

Author(s):

Sandrine Valade ◽

Laurent Raskine ◽

Mounir Aout ◽

Isabelle Malissin ◽

Pierre Brun ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Mechanical Ventilation ◽

Multivariate Analysis ◽

Intensive Care ◽

Pulmonary Tuberculosis ◽

Tuberculosis Patients ◽

Independent Variables ◽

Related Mortality

BACKGROUND: Despite effective treatments, tuberculosis-related mortality remains high among patients requiring admission to the intensive care unit (ICU).OBJECTIVE: To determine prognostic factors of death in tuberculosis patients admitted to the ICU, and to develop a simple predictive scoring system.METHODS: A 10-year, retrospective study of 53 patients admitted consecutively to the Hôpitaux de Paris, Hôpital Lariboisière (Paris, France) ICU with confirmed tuberculosis, was conducted. A multivariate analysis was performed to identify risk factors for death. A predictive fatality score was determined.RESULTS: Diagnoses included pulmonary tuberculosis (96%) and tuberculous encephalomeningitis (26%). Patients required mechanical ventilation (45%) and vasopressor infusion (28%) on admission. Twenty patients (38%) died, related to direct tuberculosis-induced organ failure (n=5), pulmonary bacterial coinfections (n=14) and pulmonary embolism (n=1). Using a multivariate analysis, three independent factors on ICU admission were predictive of fatality: miliary pulmonary tuberculosis (OR 9.04 [95% CI 1.25 to 65.30]), mechanical ventilation (OR 11.36 [95% CI 1.55 to 83.48]) and vasopressor requirement (OR 8.45 [95% CI 1.29 to 55.18]). A score generated by summing these three independent variables was effective at predicting fatality with an area under the ROC curve of 0.92 (95% CI 0.85 to 0.98).CONCLUSIONS: Fatalities remain high in patients admitted to the ICU with tuberculosis. Miliary pulmonary tuberculosis, mechanical ventilation and vasopressor requirement on admission were predictive of death.

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Determination of cardiac output during mechanical ventilation by electrical bioimpedance or thermodilution in patients with acute lung injury

Critical Care Medicine ◽

10.1097/00003246-199808000-00035 ◽

1998 ◽

Vol 26 (8) ◽

pp. 1441-1445 ◽

Cited By ~ 18

Author(s):

Michele Genoni ◽

Paolo Pelosi ◽

Jacques A. Romand ◽

Alessia Pedoto ◽

Tiziano Moccetti ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cardiac Output ◽

Acute Lung Injury ◽

Lung Injury ◽

Electrical Bioimpedance

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Determination of efficacy and toxicity of diclofenac microemulsion formulation for musculoskeletal pain: an observational study

10.21203/rs.2.21590/v2 ◽

2020 ◽

Author(s):

Hoan Linh Banh ◽

Andrew Cave

Keyword(s):

Observational Study ◽

Musculoskeletal Pain ◽

Severe Pain ◽

Pain Scale ◽

Over The Counter ◽

Hydrophilic Drug ◽

Oral Agents ◽

Minimal Improvement ◽

Lost To Follow Up

Abstract OBJECTIVE : Musculoskeletal pain is often caused by injury to the bones, muscles, tendons, ligaments or nerves. Symptoms can be localized or generalized. Mild-moderate symptoms are treated with topical/oral over the counter drugs. Microemulsion delivery formulations are thermodynamically stable, have superior bioavailability and better penetration of lipophilic and hydrophilic drug into the dermis. A prospective observational study in patients: 18 years or older, with mild-moderate musculoskeletal pain; with severe pain without adequate pain control; with severe pain and could not tolerate oral agents; with renal impairment were invited to try diclofenac 2% in microemulsion foam. They were followed up at 2 and 4 weeks. A 50% reduction on a visual analog pain scale was considered success. Adverse events were defined as irritation, gastrointestinal upset/bleed, rectal bleed, and hematemesis. The objective was to determine the efficacy and toxicity of diclofenac 2% in microemulsion foam. RESULTS : Thirteen consecutive patients with musculoskeletal pain consented to participate. Two patients were lost to follow up. Two of the 11 patients reported minimal improvement, while nine patients reported minimum 50% reduction. No adverse effects were reported. Diclofenac 2% in microemulsion foam is effective in the treatment of mild to moderate musculoskeletal pain and well tolerated.

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Use of the product of driving pressure and respiratory rate for predicting failure of weaning from mechanical ventilator in medical patients

10.21203/rs.2.24506/v1 ◽

2020 ◽

Author(s):

Ju Gong ◽

Bibo Zhang ◽

Xiaowen Huang ◽

Bin Li ◽

Jian Huang

Keyword(s):

Mechanical Ventilation ◽

Respiratory Rate ◽

Spontaneous Breathing Trial ◽

Plateau Pressure ◽

Driving Pressure ◽

Medical Patients ◽

Failure Group ◽

Weaning Failure ◽

Weaning Outcome

Abstract Background : Respiratory workload increment in the process of mechanical ventilation withdrawal is critical for the determination of weaning outcome. Pressure, tidal volume (Vt) and respiratory rate (RR ) are considered as patient’s respiratory power, albeit being affected by excessive respiratory load. We aimed to evaluate the performance of driving pressure (DP)×RR to predict the outcome of weaning. Methods : Plateau pressure (Pplat) and positive end-expiratory pressure tot (PEEPtot) were measured during mechanical ventilation, viz., (1) brief deep sedation, (2) on volume support ventilation of MV with Vt 6 ml/kg and a PEEP of 0 cm H 2 O, (3) Pplat and PEEPtot were measured by holding breath for 2s after inhalation and exhalation, respectively. The DP was determined as Pplat minus PEEPtot. The highest RR was recorded within 3 min during spontaneous-breathing trial (SBT). Patients that were able to tolerate SBT for 1 h were directly extubated. These measurements correlated well with weaning outcome. Notably, patients in the “failure” group failed the SBT, died, while others required reintubation or noninvasive ventilation within 48 h of extubation. Results : Out of the 61 patients studied, 22 failed weaning. During the withdrawal of ventilation, DP×RR was 134.2±33.2 cmH 2 O ·breaths/min and 238.5±61.7 cmH 2 O·breaths/min ( P =0.00), DP was 7.9±1.6 cmH 2 O and 9.7±2.3 cmH 2 O ( P =0.00), in the “success” and “failure” groups, respectively. The DP×RR index greater than 170 cmH 2 O·breaths/min had a sensitivity of 95.5% and a specificity of 89.7%, while DP index greater than 8.1 cmH 2 O had 81.8% sensitivity and 64.1% specificity to predict weaning failure. Conclusions : Measurement of DP×RR during withdrawal of ventilation may help predict weaning outcome. Noticeably, high DP×RR increased the likelihood of weaning failure.

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