Skin conductance as a measure of discomfort in artificial ventilated children
Skin Conductance (SC) as a measure of arousal may be a tool for monitoring discomfort in artificial ventilated children. When an outgoing sympathetic nervous burst occurs to the skin, the palmar and plantar sweat glands are filled up, and the SC increases before the sweat are removed and the SC decreases. This creates a SC fluctuation. The reaction time is fast, down to 1-2 seconds. The purpose of this study was to examine how the changes of SC, blood pressure and heart rate were associated to changes in the modified COMFORT sedation score during suction from trachea in artificial ventilated children that are circulatory stable. Twenty children from one day to eleven years were included. Sixteen were intubated after major thorasic or abdominal surgery and four were intubated due to pulmonary diseases. Number of SC fluctuations (NSCF), mean SC level, intra-arterial blood pressure, heart rate and the modified COMFORT sedation score were recorded for 2 minutes before, during and after suction from trachea and correlated with the modified COMFORT sedation score. The NSCF (p=0.002), the mean SC level (p=0.004), the blood pressure (p=0.000) and the modified COMFORT sedation score (p=0.000) increased significantly during suction from trachea, different from the heart rate. The increase in NSCF from before to during and from during to after suction from trachea correlated with the change in the modified COMFORT sedation score r2=0.61 (p=0,000) and r2=046 (p=0.001), different from the other variables. This may indicate that NSCF is a better measure than blood pressure and heart rate to monitor discomfort in artificial ventilated children that are circulatory stable.