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Je tiefer die Sedierung, je h\u00f6her die Dosis applizierter Analgetika, desto schwieriger ist die Einsch\u00e4tzung von Schmerz und Sedierungsgrad. Daher gewinnen apparative Messverfahren, wie die Messung der Reizschwelle des nozizeptiven Flexorenreflexes (NFRT), zunehmend an Bedeutung.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ziel der Arbeit<\/jats:title>\n                <jats:p>Ziel der vorliegenden Studie ist es, eine m\u00f6gliche Assoziation zwischen der H\u00f6he des nozizeptiven Flexorenreflexes, der Mortalit\u00e4t und dem Auftreten eines Delirs zu untersuchen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material und Methodik<\/jats:title>\n                <jats:p>Durch die retrospektive Analyse eines 57\u00a0Intensivpatienten umfassenden Pilotdatensatzes der interdisziplin\u00e4ren operativen Intensivstation des Universit\u00e4tsklinikums Ulm, erhoben zwischen November 2018 und M\u00e4rz 2020, wurde in einem adjustierten logistischen Regressionsmodell eine m\u00f6gliche Assoziation zwischen NFRT, Mortalit\u00e4t und Delirinzidenz berechnet. Je nach Cut-off-Wert ergeben sich Reizschwellenkorridore mit folgenden Vergleichspaaren: &lt;\u202f20\u202fmA vs. 20\u201340\u202fmA\/20\u201350\u202fmA\/20\u201360\u202fmA, &gt;\u202f40\u202fmA vs. 20\u201340\u202fmA, &gt;\u202f50\u202fmA vs. 20\u201350\u202fmA, &gt;\u202f60\u202fmA vs. 20\u201360\u202fmA. Die Ergebnisdarstellung erfolgt als Odds Ratios, bereinigt um Alter, Geschlecht, Gr\u00f6\u00dfe, TISS-28, SAPS\u00a0II, RASS, BPS und die verwendeten Analgetika. Die Schmerzerfassung erfolgte in der untersuchten Gruppe standardisiert mittels der Behavioral Pain Scale sowie erg\u00e4nzend durch die NFRT-Messung.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Es konnte eine statistisch nicht signifikante Tendenz zu einer Mortalit\u00e4tszunahme bei einer NFRT\u202f&gt;\u200950\u202fmA gegen\u00fcber dem Reizschwellenkorridor von 20\u201350\u202fmA ermittelt werden (OR\u00a03.3, KI: 0,89\u201312.43, <jats:italic>p<\/jats:italic>\u202f=\u20090,07). Eine Tendenz zu einer Reduktion der Delirh\u00e4ufigkeit trat bei einer NFRT\u202f&lt;\u200920\u202fmA gegen\u00fcber einem Reizschwellenkorridor von 20\u201340\u202fmA auf (OR 0.40, KI: 0,18\u20130,92, <jats:italic>p<\/jats:italic>\u202f=\u20090,03).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Diskussion<\/jats:title>\n                <jats:p>Anhand der H\u00f6he der NFRT kann zum aktuellen Zeitpunkt keine Empfehlung zur Anpassung des verwendeten Analgosedierungsregimes beim kritisch kranken, nichtmitteilungsf\u00e4higen Intensivpatienten gegeben werden. Die Beobachtung einer Tendenz hin zu einer Zunahme der Mortalit\u00e4t bei hohen Reizschwellen bzw. einer Reduktion des Auftretens eines Delirs bei niedrigen Reizschwellen muss in standardisierten Studien \u00fcberpr\u00fcft werden.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00101-022-01206-8","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T10:02:51Z","timestamp":1664272971000},"page":"921-929","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Potenzieller Einfluss der Reizschwellenh\u00f6he des nozizeptiven Flexorenreflex (NFRT) auf die Mortalit\u00e4ts- und Delirinzidenz beim kritisch kranken Patienten: eine retrospektive Kohortenanalyse","Potential effect of the stimulus threshold level of the nociceptive flexion reflex (NFRT) on mortality and delirium incidence in the critically ill patient: a\u00a0retrospective cohort analysis"],"prefix":"10.1007","volume":"71","author":[{"given":"B.","family":"Schick","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Walter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Gruss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Jungwirth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Barth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,27]]},"reference":[{"key":"1206_CR1","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1213\/ANE.0b013e3181c3119e","volume":"110","author":"SJGM Ahlers","year":"2010","unstructured":"Ahlers\u00a0SJGM, van der Veen\u00a0AM, van Dijk\u00a0M et\u00a0al (2010) The use of the behavioral pain scale to assess pain in conscious sedated patients. 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