ICU sedation, delirium & recovery
Performance of the Nociception Level Index and the PainSensor to predict and detect responsiveness to nociceptive procedures in critical care patients
Authors' conclusion
Both nociception monitors can predict behavioral responsiveness to nociceptive clinical stimulation. However, the added value of nociception monitors for detecting pain and nociception in critical care patients remains questionable, as readily available non-technical observational scales show a comparable performance.
Study context
- Population
- Critical care patients undergoing endotracheal suctioning or positioningsuctioning 149, positioning 47
- Participants
- 196 patients
- Comparison
- NOL and PainSensor vs Richmond Agitation-Sedation Scale (RASS) to predict behavioral responsiveness
- Outcome
- Prediction of behavioral responsiveness (Behavioral Pain Scale), assessed by prediction probability
Performance
As reported in the abstract
Prediction probability, endotracheal suctioning
NOL
0.67
prediction probability · 95% CI 0.61–0.74
PainSensor
0.57
prediction probability · 95% CI 0.51–0.63
RASS
0.73
prediction probability · 95% CI 0.68–0.77
Further findings
Prediction probability
| Outcome | NOL | PainSensor | RASS |
|---|---|---|---|
| Prediction probability, positioning | 0.80 (95% CI 0.66–0.94) | 0.54 (95% CI 0.40–0.67) | 0.68 (95% CI 0.56–0.80) |
Prediction probability, positioning
- Predicted by NOL but not PainSensor; neither outperformed the RASS
Original publication
Performance of the Nociception Level Index and the PainSensor to predict and detect responsiveness to nociceptive procedures in critical care patients. J Crit Care. Published 16 April 2025. doi:10.
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