ABSTRACT
OBJECTIVES: To evaluate the use of vital signs for pain detection in brain-injured patients in the intensive care unit. DESIGN: A repeated-measures descriptive-correlational study. SETTING: Two neurological intensive care units in Montréal, Canada. A total of 101 brain-injured patients were included. MAIN OUTCOME MEASURES: This study examined the fluctuations in systolic and diastolic blood pressure, heart and respiratory rates, and oxygen saturation in brain-injured critically ill patients before, during, and 15â¯minutes after turning and soft touch using a data collection computer. When possible, patients' pain self-reports were obtained using a 0-10 Faces Pain Thermometer. RESULTS: The heart and respiratory rates were higher during turning than soft touch and higher during the procedure compared to prior (pâ¯<â¯0.05), but their fluctuation was modest. The systolic blood pressure increased during both turning and soft touch by 2â¯mmHg, but was 26.6â¯mmHg higher for those who reported pain versus no pain (Mann-Whitneyâ¯=â¯25.00, pâ¯=â¯0.008, nâ¯=â¯28). A moderate correlation was observed between the systolic blood pressure (Spearman's rhoâ¯=â¯0.617, pâ¯=â¯0.004, nâ¯=â¯24) and self-reported pain intensity during turning. No significant effects were observed for diastolic blood pressure and oxygen saturation. CONCLUSION: Only increases in systolic blood pressure were positively associated with pain in this sample and replication studies with larger samples is needed.