Application of the Chinese version of Critical-Care Pain Observation Tool in patients undergoing invasive mechanical ventilation

Abstract:

Objective：To investigate the behavioral response and physiological reaction to pain before，during，and after the turning procedure in patients undergoing invasive mechanical ventilation，with the application of the Chinese version of Critical-Care Pain Observation Tool（CPOT）. Methods：A total of 120 patients who underwent invasive mechanical ventilation in the intensive care unit （ICU） in Department of Respiratory Medicine in a tertiary general hospital from January 2015 to January 2017 were enrolled. The Chinese version of CPOT was used to observe pain response at three stages of the turning procedure（at 1 minute before the turning procedure，during the turning procedure，and at 10 minutes after the turning procedure）. The scores of CPOT and each item，related physiological indices（mean arterial pressure，heart rate，respiratory rate，and blood oxygen saturation），and percentage of observations with a score of 1 to 2 points on each item of the CPOT scale were recorded at the three stages of the turning procedure. The scores of CPOT and each item and related physiological indices were compared between stages. Results：The score of CPOT was 0.35±0.99 at 1 minute before the turning procedure，1.96±1.77 during the procedure，and 0.12±0.58 at 10 minutes after the procedure. Compared with baseline levels，facial expression had the greatest increase as high as 72%，followed by body movements as high as 47%，compli－ance with mechanical ventilation as high as 36%，and muscle tension as high as 36%. There were significant changes in CPOT score and physiological indices in different stages of the turning procedure（P<0.05）. Conclusion：Observation of behavioral and physiological changes during the turning procedure helps medi－cal staff to perform an objective evaluation of pain in critically ill patients with impaired verbal communication. The Chinese version of CPOT scale can effectively measure the pain process in pa－tients and thus holds promise for clinical application in patients undergoing invasive mechanical ventilation.