Skin conductance versus the modified COMFORT sedation score as a measure of discomfort in artificially ventilated children
Skin conductance versus the modified COMFORT sedation score as a measure of discomfort in artificially ventilated children
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DOI：
10.1542/peds.2007-2545
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发表时间：
2008-10-01
期刊：
影响因子：
8
通讯作者：
Storm, Hanne
中科院分区：
文献类型：
--
作者：
Gjerstad, Ann Christin;Wagner, Kari;Storm, Hanne
客观的。我们希望使用皮肤电导来衡量人工通气儿童压力增加的程度。目的是检查皮肤电导、动脉血压和心率的变化如何与气管抽吸期间改良的 COMFORT 镇静评分的变化相关。伤害性刺激会引起皮肤交感神经的传出爆发，手掌和足底汗腺被充满，从而产生皮肤电导波动。方法。研究对象为 20 名 1 天至 11 岁的儿童。所有患者均接受人工通气且循环稳定。数据是在气管内抽吸之前、期间和之后 10 分钟获得的。记录并测试气管吸痰前、吸痰中、吸痰中、吸痰后的皮肤电导波动次数、皮肤电导波动幅度、平均皮肤电导水平、动脉血压、心率和改良COMFORT镇静评分。 结果。与心率和皮肤电导波动幅度相比，气管抽吸期间皮肤电导波动的数量、平均皮肤电导水平、动脉血压和改良的 COMFORT 镇静评分增加。气管内抽吸之前到期间以及期间到之后的皮肤电导波动次数与改良 COMFORT 镇静评分的变化相关。这与其他没有变化的变量形成鲜明对比。结论。气管内吸引过程中皮肤电导波动的次数与改良 COMFORT 镇静评分的增加的相关性优于心率和动脉血压。因此，皮肤电导波动的数量似乎是对改良 COMFORT 镇静评分的客观补充，用于监测人工通气和循环稳定儿童的压力增加。
OBJECTIVE. We wanted to use skin conductance as a measure of increased stress in artificially ventilated children. The aim was to examine how changes in skin conductance, arterial blood pressure, and heart rate are associated with changes in the modified COMFORT sedation score during suction from the trachea. Nociceptive stimulation induces an outgoing sympathetic nervous burst to the skin and the palmar and plantar sweat glands are filled, which creates a skin conductance fluctuation.METHODS. Twenty children who were 1 day to 11 years of age were studied. All patients were artificially ventilated and circulatory stable. The data were obtained before, during, and 10 minutes after endotracheal suction. The number of skin conductance fluctuations, the amplitude of skin conductance fluctuations, the mean skin conductance level, arterial blood pressure, heart rate, and the modified COMFORT sedation score were recorded and tested from before to during and from during to after suction in the trachea.RESULTS. The number of skin conductance fluctuations, mean skin conductance level, arterial blood pressure, and the modified COMFORT sedation score increased during suction in the trachea, in contrast to heart rate and amplitude of skin conductance fluctuations. The number of skin conductance fluctuations from before to during and from during to after endotracheal suctioning correlated with changes in the modified COMFORT sedation score. This was in contrast to the other variables that did not.CONCLUSIONS. The number of skin conductance fluctuations during endotracheal suctioning showed better correlation with the increase in the modified COMFORT sedation score than heart rate and arterial blood pressure. Thus, the number of skin conductance fluctuations seems to be an objective supplement to the modified COMFORT sedation score for monitoring increased stress in artificially ventilated and circulatory stable children.