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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
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Functional outcomes in ICU – what should we be using? – an observational study.
Selina M Parry1, Linda Denehy2,3, Lisa J Beach4
1Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry St, Parkville, 3010, Melbourne, VIC, Australia. parrys@unimelb.edu.au.
Critical Care (London, England)
|April 19, 2015
Summary
The Physical Function in Intensive care Test scored (PFIT-s) and Functional Status Score for the ICU (FSS-ICU) are recommended for measuring ICU patient function. These tests show high validity and applicability for rehabilitation assessments.
Area of Science:
- Rehabilitation Medicine
- Critical Care Medicine
- Clinical Assessment
Background:
- Growing need for validated functional measures in intensive care units (ICUs).
- Existing 26 measures for ICU survivors lack comparative data.
- Physical Function in Intensive care Test scored (PFIT-s) has established clinimetric properties.
Purpose of the Study:
- Evaluate criterion validity of Functional Status Score for the ICU (FSS-ICU), ICU Mobility Scale (IMS), and Short Physical Performance Battery (SPPB) against PFIT-s.
- Assess construct validity of these tests against muscle strength.
- Determine predictive utility for discharge to home and clinical applicability.
Main Methods:
- Nested study within an ongoing controlled and observational study.
- Assessed 66 individuals at awakening and ICU discharge.
- Utilized PFIT-s, FSS-ICU, IMS, SPPB; analyzed using Spearman's rank correlation and logistic regression.
Main Results:
- PFIT-s demonstrated strong relationships with FSS-ICU (rho=0.87), IMS (rho=0.81), and SPPB (rho=0.70) at awakening.
- PFIT-s showed excellent construct validity (rho=0.8); FSS-ICU (rho=0.69) and IMS (rho=0.57) had moderate validity with muscle strength.
- SPPB exhibited large floor effects (78% at awakening, 56% at discharge), unlike PFIT-s and FSS-ICU.
Conclusions:
- High criterion validity exists for FSS-ICU, IMS, and SPPB against PFIT-s.
- PFIT-s and FSS-ICU demonstrate promising clinimetric properties for ICU use.
- PFIT-s and FSS-ICU are recommended for measuring functional status in ICU survivors.
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