Use of Pupillometry for Pain Assessment in ICU Patients with Delirium
NCT ID: NCT05811208
Last Updated: 2024-11-20
Study Results
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Basic Information
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RECRUITING
50 participants
OBSERVATIONAL
2023-05-01
2026-01-01
Brief Summary
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Patients in intensive care are prone to delirium. Delirium can compromise patients' ability to verbalise pain for a variety of reasons (e.g. due to impaired attention, memory, thinking and language barriers). Also, pain and inadequate analgesia are risk factors for delirium.
Pupillary reflex changes and their identification by automated pupillometry have yielded positive results regarding nociception assessment in adult and pediatric patients and in perioperative and postoperative care. At the same time, the response of these patients to opioid administration was investigated. The aim was to improve their analgesia.
The aim of this study is to find out whether, there is an association between automated pupillometry and selected objective pain measurement scales in The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) positive patients after surgery.
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Detailed Description
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Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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surgical ICU patients
All surgical patients on the inpatient ward in the Department of Anesthesiology and Intensive Care
automated pupillometry
Automated pupillometry every 6 hours
questionnaire
CAM ICU questionnaire will be used for delirium screening the incidence of pain will be assessed using 3 valid scales. The Visual Analogue Scale (VAS), the Behavioral Pain Scale (BPS) and the Critical Care Observational Tool (CPOT) will be used.
questionnaires will be done the same time as pupillometry
Interventions
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automated pupillometry
Automated pupillometry every 6 hours
questionnaire
CAM ICU questionnaire will be used for delirium screening the incidence of pain will be assessed using 3 valid scales. The Visual Analogue Scale (VAS), the Behavioral Pain Scale (BPS) and the Critical Care Observational Tool (CPOT) will be used.
questionnaires will be done the same time as pupillometry
Eligibility Criteria
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Inclusion Criteria
* possibility to perform CAM - ICU test (patients with Richmond Agitation-Sedation Scale -2 to +2)
Exclusion Criteria
* brain injury
* stroke
* epilepsy
* neuromuscular diseases
18 Years
ALL
No
Sponsors
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St. Anne's University Hospital Brno, Czech Republic
OTHER
Responsible Party
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Ivan Cundrle
Clinical Professor
Principal Investigators
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Patrik Mica, MSc
Role: PRINCIPAL_INVESTIGATOR
St. Anne's University Hospital
Locations
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St. Anne's University Hospital in Brno
Brno, Czech Republic, Czechia
Countries
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Central Contacts
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Facility Contacts
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Marketa Fialova, RN
Role: backup
Hana Behunkova, Bc
Role: backup
Radka Kvicalova, RN
Role: backup
Alena Gregrova, RN
Role: backup
References
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Alvarez EA, Parada FJ. Association of Pain During the Evaluation of Delirium in Intensive Care Unit Patients. Front Med (Lausanne). 2021 Aug 24;8:722001. doi: 10.3389/fmed.2021.722001. eCollection 2021. No abstract available.
Azevedo-Santos IF, DeSantana JM. Pain measurement techniques: spotlight on mechanically ventilated patients. J Pain Res. 2018 Nov 21;11:2969-2980. doi: 10.2147/JPR.S151169. eCollection 2018.
Fischer T, Hosie A, Luckett T, Agar M, Phillips J. Strategies for Pain Assessment in Adult Patients With Delirium: A Scoping Review. J Pain Symptom Manage. 2019 Sep;58(3):487-502.e11. doi: 10.1016/j.jpainsymman.2019.05.020. Epub 2019 Jun 10.
Rijkenberg S, van der Voort PH. Can the critical-care pain observation tool (CPOT) be used to assess pain in delirious ICU patients? J Thorac Dis. 2016 May;8(5):E285-7. doi: 10.21037/jtd.2016.03.32. No abstract available.
Favre E, Bernini A, Morelli P, Pasquier J, Miroz JP, Abed-Maillard S, Ben-Hamouda N, Oddo M. Neuromonitoring of delirium with quantitative pupillometry in sedated mechanically ventilated critically ill patients. Crit Care. 2020 Feb 24;24(1):66. doi: 10.1186/s13054-020-2796-8.
Tosi F, Gatto A, Capossela L, Ferretti S, Mancino A, Curatola A, Chiaretti A, Pulitano S. Role of the pupillometer in the assessment of pain in the sedation of pediatric patients. Eur Rev Med Pharmacol Sci. 2021 Oct;25(20):6349-6355. doi: 10.26355/eurrev_202110_27008.
Lukaszewicz AC, Dereu D, Gayat E, Payen D. The relevance of pupillometry for evaluation of analgesia before noxious procedures in the intensive care unit. Anesth Analg. 2015 Jun;120(6):1297-300. doi: 10.1213/ANE.0000000000000609.
Other Identifiers
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11V/2023
Identifier Type: -
Identifier Source: org_study_id
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