Electrodermal Activity Monitoring During Painful Stimulation in Sedated Adult Intensive Care Unit Patients: a Pilot Study

Aslanidis, Theodoros; Grosomanidis, Vasilios; Karakoulas, K.; Chatzisotiriou, Athanasios

doi:10.14712/18059694.2018.50

Cited by 8 publications

(3 citation statements)

References 22 publications

(21 reference statements)

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“…EDA measurement has been shown to be more sensitive than vital signs and BIS measurements in detecting pain in sedated patients in the ICU [ 85 ]. Among healthy volunteers, tt had good sensitivity, specificity and accuracy in detecting stress [ 84 , 86 ] and could discriminate between stress and cognitive load [ 82 ].…”

Section: Resultsmentioning

confidence: 99%

Noninvasive monitoring technologies to identify discomfort and distressing symptoms in persons with limited communication at the end of life: a scoping review

Xu,

Smaling,

Schoones

et al. 2024

BMC Palliat Care

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Background Discomfort and distressing symptoms are common at the end of life, while people in this stage are often no longer able to express themselves. Technologies may aid clinicians in detecting and treating these symptoms to improve end-of-life care. This review provides an overview of noninvasive monitoring technologies that may be applied to persons with limited communication at the end of life to identify discomfort. Methods A systematic search was performed in nine databases, and experts were consulted. Manuscripts were included if they were written in English, Dutch, German, French, Japanese or Chinese, if the monitoring technology measured discomfort or distressing symptoms, was noninvasive, could be continuously administered for 4 hours and was potentially applicable for bed-ridden people. The screening was performed by two researchers independently. Information about the technology, its clinimetrics (validity, reliability, sensitivity, specificity, responsiveness), acceptability, and feasibility were extracted. Results Of the 3,414 identified manuscripts, 229 met the eligibility criteria. A variety of monitoring technologies were identified, including actigraphy, brain activity monitoring, electrocardiography, electrodermal activity monitoring, surface electromyography, incontinence sensors, multimodal systems, and noncontact monitoring systems. The main indicators of discomfort monitored by these technologies were sleep, level of consciousness, risk of pressure ulcers, urinary incontinence, agitation, and pain. For the end-of-life phase, brain activity monitors could be helpful and acceptable to monitor the level of consciousness during palliative sedation. However, no manuscripts have reported on the clinimetrics, feasibility, and acceptability of the other technologies for the end-of-life phase. Conclusions Noninvasive monitoring technologies are available to measure common symptoms at the end of life. Future research should evaluate the quality of evidence provided by existing studies and investigate the feasibility, acceptability, and usefulness of these technologies in the end-of-life setting. Guidelines for studies on healthcare technologies should be better implemented and further developed.

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Section: Resultsmentioning

confidence: 99%

Noninvasive monitoring technologies to identify discomfort and distressing symptoms in persons with limited communication at the end of life: a scoping review

Xu,

Smaling,

Schoones

et al. 2024

BMC Palliat Care

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“…28 Furthermore, in another study RFP was proposed to be the most accurate to handle medical applications. 29 Results from this study were built on previous results, either on the use of an electrodermal activity to measure emotional responses, 30,31 but also on developing a mobile application to display and visualize the emotional state of clients with a severe or profound intellectual disability. [4][5][6] With an accuracy between 80% and 93% and precision of 0.88 the app will provide a useful tool to, for example, aid caregivers of those unable to communicate or express their pain, providing more certainty and decreasing possible work stress.…”

Section: Discussionmentioning

confidence: 99%

“…Electrodermal activity has been shown to increase in response to noxious stimuli, such as stress and pain, 1,[4][5][6]30,31 but responses can vary between people. 9 Circumstances, such as room temperature and time of day, and personal differences, such as race, age and BMI 32 also influence skin conductance responses.…”

Section: Discussionmentioning

confidence: 99%

Development of an AI-Enabled System for Pain Monitoring Using Skin Conductance Sensoring in Socks

Korving

Zhou

Xiang

et al. 2022

Int. J. Neur. Syst.

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Background: Where self-report is unfeasible or observations are difficult, physiological estimates of pain are needed. Methods: Pain-data from 30 healthy adults were gathered to create a database of physiological pain responses. A model was then developed, to analyze pain-data and visualize the AI-estimated level of pain on a mobile app. Results: The initial low precision and F1-score of the pain classification algorithm were resolved by interpolating a percentage of similar data. Discussion: This system presents a novel approach to assess pain in noncommunicative people with the use of a sensor sock, AI predictor and mobile app. Performance analysis and the limitations of the AI algorithm are discussed.

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Normalized skin conductance level could differentiate physical pain stimuli from other sympathetic stimuli

Sugimine

Saito

Takazawa

2020

Sci Rep

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Skin conductance monitoring is one of the promising methods for objectively evaluating pain. However, skin conductance might possibly increase in response to sympathetic stimulation other than pain. In this study, we aimed to test whether skin conductance monitoring can distinguish physical pain stimulation (heat, mechanical and cold stimulation) from other sympathetic stimuli (stimulation by noise and painful images). Twenty-three healthy volunteers participated in this prospective observational study. The number of fluctuations in skin conductance (NFSC) and normalized skin conductance level (nSCL) were measured and compared with pain scores on a self-reported pain scale (numerical pain scale [NPS]). Both NFSC and nSCL increased during mechanical stimulation. Further, nSCL, but not NFSC, well reflected heat stimulus intensity, suggesting its ability to quantitatively evaluate pain. nSCLs during physical pain stimulation were greater than those during other sympathetic stimulations. However, NFSC was not able to completely distinguish between the stimuli. These results suggest that nSCL could better differentiate physical pain stimuli from other sympathetic stimuli than NFSC. In comparisons between subjective and objective pain assessment in the same individual, nSCL correlated better with NPS score, indicating the possibility of being able to monitor the transition of pain. Monitoring changes in skin conductance using nSCL might be useful for objectively detecting physical pain. Psychometric response scales, such as the visual analogue scale, have been widely used for assessment of pain 1. This seems to be reasonable because the sensation of pain is usually affected by psychogenic factors, including mood, attention, anxiety, expectation, hypnosis and empathy 2. This fact is reflected in the following definition of pain by the International Association for the Study of Pain: An unpleasant sensory and emotional experience with actual or potential tissue damage, or described in terms of such damage 3. However, an objective pain assessment tool is still required, because verbal expression of pain is difficult for certain individuals, such as children, mentally-handicapped persons and intubated and sedated patients. Numerous studies regarding objective pain assessment have been conducted, and several physiological markers of pain, such as heart rate variability and pupillary reflexes, were proposed. However, none of them has been established as a validated marker for pain assessment so far 4,5. Among the different markers proposed, changes in skin conductance might be promising. Activation of sympathetic nerves in the skin following the experience of pain sensation and/or certain emotions, including fear and excitement, results in sweating in the palmar and plantar areas, which in turn increases skin conductance in these areas. Hence, the rationale for development of the skin conductance monitor was to detect changes in skin conductance over time 6. The principle of the skin conductance monitor raised the question r...

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Electrodermal Activity Monitoring During Painful Stimulation in Sedated Adult Intensive Care Unit Patients: a Pilot Study

Abstract: EDA measurements are greater to pain stimuli, than cardiovascular, respiratory or even BIS monitoring. These encouraging results suggest that, further studies are needed to better define EDA role in ICU.

Cited by 8 publications

References 22 publications

Noninvasive monitoring technologies to identify discomfort and distressing symptoms in persons with limited communication at the end of life: a scoping review

Noninvasive monitoring technologies to identify discomfort and distressing symptoms in persons with limited communication at the end of life: a scoping review

Development of an AI-Enabled System for Pain Monitoring Using Skin Conductance Sensoring in Socks

Normalized skin conductance level could differentiate physical pain stimuli from other sympathetic stimuli

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