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  • Responses to noxious stimuli in sedated mechanically ventilated adults.

Responses to noxious stimuli in sedated mechanically ventilated adults.

Heart & lung : the journal of critical care (2013-11-19)
Mary Jo Grap, Cindy L Munro, Paul A Wetzel, Jessica M Ketchum, V Anne Hamilton, Curtis N Sessler
ABSTRACT

To determine the effect of sedation on physiologic responses and comfort before, during and after a noxious stimulus (endotracheal tube suctioning). The sample was a subset of a larger, longitudinal descriptive study, blood for endorphins and saliva for alpha-amylase were obtained before and after suctioning. Heart rate (HR), respiration rate (RR), oxygen saturation (SPO2), and arm and leg actigraphy were continuously recorded. 67 subjects from medical and surgical ICUs were primarily deeply (37%) or mildly sedated (54%) prior to suctioning. Alpha-amylase increased post suctioning (p = 0.04); endorphins did not change (p = 0.58). Neither were modified by sedation. There were no changes in HR, RR or SPO2 post suctioning. Arm (p = 0.007) and leg actigraphy (p = 0.057) changed from baseline and depended on sedation level (p = 0.0005). While a stress marker did increase during suctioning, only the measure of patient arm movement was significantly affected by sedation level.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Taka-Diastase from Aspergillus oryzae, powder, slightly beige, ~100 U/mg
Sigma-Aldrich
α-Amylase from Bacillus sp., powder, yellow-brown, ~50 U/mg
Sigma-Aldrich
α-Amylase from Bacillus sp., powder, yellow-brown, ~380 U/mg
Sigma-Aldrich
α-Amylase from Bacillus sp., powder, ≥400 units/mg protein (Lowry)
Sigma-Aldrich
α-Amylase from porcine pancreas, PMSF Treated, Type I-A, saline suspension, ≥1000 units/mg protein (E1%/280)
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α-Amylase from porcine pancreas, Type I-A, PMSF treated, saline suspension, 700-1400 units/mg protein (E1%/280)
Sigma-Aldrich
α-Amylase, heat-stable, solution, for use in Total Dietary Fiber Assay, TDF-100A
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α-Amylase from porcine pancreas, Type VI-B, ≥5 units/mg solid
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α-Amylase from Bacillus sp., Type II-A, lyophilized powder, ≥1,500 units/mg protein (biuret)
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α-Amylase from Bacillus sp., liquid
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α-Amylase from Aspergillus oryzae, aqueous solution, ≥800 FAU/g
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α-Amylase from Bacillus amyloliquefaciens, liquid, ≥250 units/g
Sigma-Aldrich
α-Amylase from Aspergillus oryzae, ≥150 units/mg protein (biuret)
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α-Amylase from Aspergillus oryzae, powder, ~1.5 U/mg (~0.2 U acc. to Willstätter)
Sigma-Aldrich
α-Amylase from Bacillus licheniformis, Type XII-A, saline solution, ≥500 units/mg protein (biuret)
Supelco
α-Amylase from Bacillus licheniformis, suitable for determination of starch (Kit STA-20)
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α-Amylase from human saliva, Type XIII-A, lyophilized powder, 300-1,500 units/mg protein
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α-Amylase from human saliva, Type IX-A, lyophilized powder, 1,000-3,000 units/mg protein
Sigma-Aldrich
α-Amylase from Aspergillus oryzae, powder, ~30 U/mg
Sigma-Aldrich
α-Amylase from Bacillus licheniformis, lyophilized powder, 500-1,500 units/mg protein, 93-100% (SDS-PAGE)