The Nociception Level (NOL) Index for Pain Assessment in the Adult Intensive Care Unit

Launched by MCGILL UNIVERSITY · Apr 15, 2022

Keywords

ClinConnect Summary

This clinical trial is studying a new tool called the Nociception Level (NOL) index, which helps assess pain in adults in the Intensive Care Unit (ICU). Many patients in the ICU cannot communicate because they are on breathing machines or sedated, making it hard for doctors and nurses to know how much pain they are in. The NOL index uses a small probe placed on a patient's finger to measure various body responses, like heart rate and skin temperature, to give a score from 0 to 100, indicating the level of pain. The trial will look at how well the NOL can detect pain during different medical procedures, comparing it to patients who can communicate their pain and those who show signs of discomfort.

To participate in the trial, patients need to be in the ICU for more than 24 hours, speak either French or English, and be able to self-report their pain or show behavior that indicates discomfort. However, those with certain health issues, like severe heart problems or cognitive deficits, and those who are pregnant cannot take part. If someone joins the trial, they will undergo pain assessments and receive routine care while the researchers observe how well the NOL index works in identifying pain. This study could lead to better pain management for patients who are unable to express their discomfort, ultimately improving their care in the ICU.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Admitted to the ICU for more than 24 hours
• • French or English speaking
• • Able to self-report or not
• • Negative on delirium screening and not treated for psychosis (patients able to self- report)
• Exclusion Criteria:
• • Lack an available finger to install the NOL's finger probe
• • Suffer severe peripheral vascular disease affecting the upper limbs
• • Serious and uncontrolled cardiac arrhythmia
• • Are in a hypoperfusion state or shock for which they are receiving high doses of Norepinephrine (\>14 mcg/min) or equivalent vasopressors to maintain a SBP \>90mmHg or a MAP \>65mmHg
• • Are agitated (RASS scores from +1 to +4)
• • Diagnosed with cognitive deficits (e.g., Alzheimer)
• • Are positive for C. Difficile
• • Are pregnant