Responses to noxious stimuli in sedated mechanically ventilatedadults

Mary Jo Grap; Cindy L. Munro; Paul A. Wetzel; Jessica M. Ketchum; V. Anne Hamilton; Curtis N. Sessler

doi:10.1016/j.hrtlng.2013.10.012

Responses to noxious stimuli in sedated mechanically ventilatedadults

Mary Jo Grap, Cindy L. Munro, Paul A. Wetzel, Jessica M. Ketchum, V. Anne Hamilton, Curtis N. Sessler

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Objective: To determine the effect of sedation on physiologic responses and comfort before, during and after a noxious stimulus (endotracheal tube suctioning). Methods: The sample was a subset of a larger, longitudinal descriptive study, blood for endorphins and saliva for alpha-amylase were obtained before and after suctioning. Heart rate (HR), respiration rate (RR), oxygen saturation (SPO₂), and arm and leg actigraphy were continuously recorded. Results: 67 subjects from medical and surgical ICUs were primarily deeply (37%) or mildly sedated (54%) prior to suctioning. Alpha-amylase increased post suctioning (p=0.04); endorphins did not change (p=0.58). Neither were modified by sedation. There were no changes in HR, RR or SPO2 post suctioning. Arm (p=0.007) and leg actigraphy (p=0.057) changed from baseline and depended on sedation level (p=0.0005). Conclusions: While a stress marker did increase during suctioning, only the measure of patient arm movement was significantly affected by sedation level.

Original language	English (US)
Pages (from-to)	6-12
Number of pages	7
Journal	Heart and Lung: Journal of Acute and Critical Care
Volume	43
Issue number	1
DOIs	https://doi.org/10.1016/j.hrtlng.2013.10.012
State	Published - Jan 2014
Externally published	Yes

Keywords

Evaluation
Mechanical ventilation
Outcomes
Sedation

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

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10.1016/j.hrtlng.2013.10.012

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title = "Responses to noxious stimuli in sedated mechanically ventilatedadults",

abstract = "Objective: To determine the effect of sedation on physiologic responses and comfort before, during and after a noxious stimulus (endotracheal tube suctioning). Methods: The sample was a subset of a larger, longitudinal descriptive study, blood for endorphins and saliva for alpha-amylase were obtained before and after suctioning. Heart rate (HR), respiration rate (RR), oxygen saturation (SPO2), and arm and leg actigraphy were continuously recorded. Results: 67 subjects from medical and surgical ICUs were primarily deeply (37%) or mildly sedated (54%) prior to suctioning. Alpha-amylase increased post suctioning (p=0.04); endorphins did not change (p=0.58). Neither were modified by sedation. There were no changes in HR, RR or SPO2 post suctioning. Arm (p=0.007) and leg actigraphy (p=0.057) changed from baseline and depended on sedation level (p=0.0005). Conclusions: While a stress marker did increase during suctioning, only the measure of patient arm movement was significantly affected by sedation level.",

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author = "Grap, {Mary Jo} and Munro, {Cindy L.} and Wetzel, {Paul A.} and Ketchum, {Jessica M.} and Hamilton, {V. Anne} and Sessler, {Curtis N.}",

year = "2014",

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doi = "10.1016/j.hrtlng.2013.10.012",

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AU - Grap, Mary Jo

AU - Munro, Cindy L.

AU - Wetzel, Paul A.

AU - Ketchum, Jessica M.

AU - Hamilton, V. Anne

AU - Sessler, Curtis N.

PY - 2014/1

Y1 - 2014/1

N2 - Objective: To determine the effect of sedation on physiologic responses and comfort before, during and after a noxious stimulus (endotracheal tube suctioning). Methods: The sample was a subset of a larger, longitudinal descriptive study, blood for endorphins and saliva for alpha-amylase were obtained before and after suctioning. Heart rate (HR), respiration rate (RR), oxygen saturation (SPO2), and arm and leg actigraphy were continuously recorded. Results: 67 subjects from medical and surgical ICUs were primarily deeply (37%) or mildly sedated (54%) prior to suctioning. Alpha-amylase increased post suctioning (p=0.04); endorphins did not change (p=0.58). Neither were modified by sedation. There were no changes in HR, RR or SPO2 post suctioning. Arm (p=0.007) and leg actigraphy (p=0.057) changed from baseline and depended on sedation level (p=0.0005). Conclusions: While a stress marker did increase during suctioning, only the measure of patient arm movement was significantly affected by sedation level.

AB - Objective: To determine the effect of sedation on physiologic responses and comfort before, during and after a noxious stimulus (endotracheal tube suctioning). Methods: The sample was a subset of a larger, longitudinal descriptive study, blood for endorphins and saliva for alpha-amylase were obtained before and after suctioning. Heart rate (HR), respiration rate (RR), oxygen saturation (SPO2), and arm and leg actigraphy were continuously recorded. Results: 67 subjects from medical and surgical ICUs were primarily deeply (37%) or mildly sedated (54%) prior to suctioning. Alpha-amylase increased post suctioning (p=0.04); endorphins did not change (p=0.58). Neither were modified by sedation. There were no changes in HR, RR or SPO2 post suctioning. Arm (p=0.007) and leg actigraphy (p=0.057) changed from baseline and depended on sedation level (p=0.0005). Conclusions: While a stress marker did increase during suctioning, only the measure of patient arm movement was significantly affected by sedation level.

KW - Evaluation

KW - Mechanical ventilation

KW - Outcomes

KW - Sedation

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Responses to noxious stimuli in sedated mechanically ventilatedadults

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Keywords

ASJC Scopus subject areas

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