Different biomarkers linked with pain in critically ill children can be easily obtained and measured in a clinical setting, a review published in the ‘Critical Care Nurse’ journal concluded.

Eleni Tamvaki and a team of researchers worked to review primary studies on endogenous biomarkers, aiming to identify appropriate relevant biomarkers for objectively assessing pain in critically ill children.

Database searches included exploring PubMed, Ovid and Scopus based on date of publication, language, and age of the participant. The quality of evidence (high, moderate, low and very low) was assessed as per the Critical appraisal worksheets and tools along with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist.

Relevant studies were coded based on methods and findings. Bodily fluids such as saliva, cerebrospinal fluid, blood and gingival crevicular oral cavity fluid were used for biomarker detection. The majority of studies (64%) employed enzyme-linked immunosorbent assays. Appropriate statistical analyses were performed of the included studies at P<.05 (significance level).

Pain, stress, and inflammatory response were linked with cytokines, peptides and hormones implying their role in screening for pain during painful conditions in pediatric patients. One neonatal study found no link between salivary biomarkers and pain.

The study researchers suggest observational studies in the future to investigate the suitability of these biomarkers for pain assessment in critically ill children.