Vital signs fluctuations and their relationship with pain in the brain-injured adult critically ill - A repeated-measures descriptive-correlational study.
OBJECTIVES
To evaluate the use of vital signs for pain detection in brain-injured patients in the intensive care unit.


DESIGN
A repeated-measures descriptive-correlational study.


SETTING
Two neurological intensive care units in Montréal, Canada. A total of 101 brain-injured patients were included.


MAIN OUTCOME MEASURES
This study examined the fluctuations in systolic and diastolic blood pressure, heart and respiratory rates, and oxygen saturation in brain-injured critically ill patients before, during, and 15 minutes after turning and soft touch using a data collection computer. When possible, patients' pain self-reports were obtained using a 0-10 Faces Pain Thermometer.


RESULTS
The heart and respiratory rates were higher during turning than soft touch and higher during the procedure compared to prior (p < 0.05), but their fluctuation was modest. The systolic blood pressure increased during both turning and soft touch by 2 mmHg, but was 26.6 mmHg higher for those who reported pain versus no pain (Mann-Whitney = 25.00, p = 0.008, n = 28). A moderate correlation was observed between the systolic blood pressure (Spearman's rho = 0.617, p = 0.004, n = 24) and self-reported pain intensity during turning. No significant effects were observed for diastolic blood pressure and oxygen saturation.


CONCLUSION
Only increases in systolic blood pressure were positively associated with pain in this sample and replication studies with larger samples is needed.
['Boitor|Madalina|M|', 'Richard-Lalonde|Mélissa|M|', 'Bérubé|Mélanie|M|', 'Émilie|Gosselin|G|', 'Gélinas|Céline|C|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000704:Analysis of Variance D001831:Body Temperature D000070642:Brain Injuries, Traumatic D000078331:Correlation of Data D016638:Critical Illness D005260:Female D006339:Heart Rate D006801:Humans D007362:Intensive Care Units D008297:Male D008875:Middle Aged D010146:Pain D010147:Pain Measurement D011792:Quebec D057566:Self Report D055986:Vital Signs
Vital signs Pain Brain injury Critical care