ICU sedation, delirium & recovery
Quantitative assessment of nociception by qNOX indices during nursing procedures of mechanically ventilated patients in ICU: A prospective observational study
Main finding · Discrimination, correlation with BPS and prediction of painResult — go to the resultOdds ratio 1.112 95% CI 1.075–1.152Authors' conclusion
qNOX exhibits a significant correlation with the BPS during nociceptive procedures in mechanically ventilated ICU patients.
Study context
- Population
- Mechanically ventilated ICU patients undergoing routine nursing procedures (endotracheal suctioning and turning)323 pain assessments
- Participants
- 102 participants
- Exposure
- qNOX vs BIS
- Outcome
- qNOX's discriminative ability (ROC analysis, AUC), correlation with Behavioral Pain Scale (BPS; Spearman's test), and predictive value (linear mixed-effects model analyses)
Main finding
As reported in the abstract
Discrimination, correlation with BPS and prediction of pain
Odds ratio
1.112
95% CI 1.075–1.152
By group
qNOX
- Specificity, suctioning
- 77.8%
- Specificity, turning
- 80.6%
- AUC, light sedation
- 0.735-0.747
- AUC, deep sedation
- 0.729-0.753
BIS
- Specificity, suctioning
- 73.3%
- Specificity, turning
- 64.5%
- AUC, light sedation
- 0.610
- AUC, deep sedation
- 0.698
Specificity, suctioning
qNOX77.8%
BIS73.3%
Specificity, turning
qNOX80.6%
BIS64.5%
AUC, light sedation
qNOX0.735-0.747
BIS0.610
AUC, deep sedation
qNOX0.729-0.753
BIS0.698
qNOXi
OR 1.112 (95% CI 1.075–1.152)
Per unit increase in qNOXi, as printed
- Correlation of qNOXm with Behavioral Pain Scale (BPS) (r)
- 0.53
- Correlation of qNOXi with BPS (r)
- 0.52
- Correlation P (both)
- P < 0.0001
- Nonlinear relationship of qNOX with BPS
- P < 0.001
Observational data: associations, not effects.
Original publication
Quantitative assessment of nociception by qNOX indices during nursing procedures of mechanically ventilated patients in ICU: A prospective observational study. J Crit Care. Published 11 March 2026. doi:10.
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