Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 9, September, p. 1117–1121

doi: 10.17219/acem/126286

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Skin conductance measurement for the assessment of analgosedation adequacy in infants treated with mechanical ventilation: A multicenter pilot study

Wojciech Walas1,A,B,C,D,E,F, Zenon Halaba2,B,C,D,E,F, Agata Kubiaczyk3,B,E,F, Andrzej Piotrowski4,C,E,F, Julita Latka-Grot5,B,C,E,F, Tomasz Szczapa3,C,E,F, Monika Romul4,B,E,F, Iwona Maroszyńska6,C,E,F, Ewelina Malinowska6,B,E,F, Magdalena Rutkowska7,B,E,F, Michał Skrzypek8,C,E,F, Robert Śmigiel9,B,C,D,E,F

1 Pediatric and Neonatal Intensive Care Unit, University Hospital in Opole, Poland

2 Department of Pediatrics, Institute of Medical Sciences, University of Opole, Poland

3 Department of Neonatology, Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, Poznań University of Medical Sciences, Poland

4 Department of Anesthesiology and Intensive Care, Children’s Memorial Health Institute, Warszawa, Poland

5 Neonatal Department, Children’s Memorial Health Institute, Warszawa, Poland

6 Department of Intensive Care and Congenital Malformations of Newborns and Infants, Polish Mother’s Memorial Hospital Research Institute in Łódź, Poland

7 Department of Neonatology, Institute of Mother and Child, Warszawa, Poland

8 Department of Biostatistics, School of Public Health in Bytom, Medical University of Silesia, Poland

9 Department of Pediatrics, Division of Propedeutic Pediatrics and Rare Disorders, Wroclaw Medical University, Poland

Abstract

Background. Patients treated in neonatal/pediatric intensive care units (N/PICUs) are frequently exposed to pain. To assess its severity, several behavioral and behavioral-physiological scales are used, but their usefulness is limited. It is therefore justified to search for additional methods to assess the adequacy of analgesia and sedation in these patients.
Objectives. To evaluate the usefulness of skin conductance (SC) measurement in the assessment of analgosedation quality in infants requiring mechanical ventilation treated in N/PICUs.
Material and Methods. Thirty infants aged 6–208 days treated in 6 N/PICUs, mechanically ventilated and receiving analgosedation, were included for the study. Simultaneous COMFORT-B assessment and SC measurement using SCA (skin conductance algesimeter) monitor were performed. Due to technical problems, not all of the SC records could be interpreted, and finally 412 simultaneous assessments on the COMFORT-B scale and SC measurements in 29 patients were analyzed.
Results. We found a statistically significant correlation between the COMFORT-B scoring and the SC measurements. Additionally, SC was significantly lower when the behavioral score indicated deep sedation, in comparison to periods when it indicated moderate or insufficient analgosedation.
Conclusion. Skin conductance measurements are comparable with the COMFORT-B rating in mechanically ventilated infants receiving analgosedation. The SCA monitor may be of value in the assessment of analgosedation quality, and in particular may identify the situation where sedation is deep. Further research is needed regarding the suitability of this device in clinical practice.

Key words

pain, analgosedation, infant, skin conductance, COMFORT-B scale

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