Nociception Level monitoring in the Intensive Care

Several monitors are available that objectively track nociception in sedated or anesthetized patients. One such monitor is used at LUMC, the Nociception level (NOL) monitor (Medasense Biometrics Ltd). In this exploratory, non-interventional trial we will monitor the nociception level index (an index ranging from 0 = absence of nociception to 100 = intense nociception) in sedated and ventilated ICU patients to get an indication of the behavior of the NOL monitor in this specific patient population. The results of this observational trial will be used to power future studies on NOL-guided opioid and sedative administration.

This is a hypothesis-free trial but expect similar behavior of the NOL-index in sedated and ventilated ICU patients compared to surgical patients.

Patients in the ICU of the LUMC will be screened for inclusion. Eligible patients will be connected to the NOL device via two electrodes and a finger cuff placed on dig. V. Although no harm has been observed from use of the finger cuff in patients treated so far at the LUMC, we will move the cuff at 4-6h intervals to another finger to ensure no skin damage due to cuff pressure. This is a preventive measure and not based on existing evidence though. Patients will be connected between 08:00 - 09:00 in the morning and will be disconnected after 8 hours of measuring.