[Evaluation of the depth of sedation in neurocritical care: clinical scales, electrophysiological methods and BIS].
The primary goal of sedation is to achieve security and comfort of mechanically ventilated ICU patients. Delivery of pharmacologic agents must avoid over sedation, which increases morbidity by prolongation of the duration of mechanical ventilation. Similarly, under sedation may favour life-threatening events such as accidental extubation. Many clinical scales have been generated to regularly measure the level of sedation (consciousness and tolerance to the ICU environment). No electrophysiological monitor (BIS) has proved reliability for measuring the depth of sedation or analgesia yet. The presence of brain damage in ICU patients makes the level of sedation impossible to interpret. Glasgow coma scale, which is exclusively devoted to the consciousness domain, is the only recommendation that can be made in neurocritical care at the present time.
Mantz
J
J
Service d'anesthésie-réanimation, faculté de médecine Xavier-Bichat, hôpital Xavier-Bichat, 46, rue Henri-Huchard, 75018 Paris, France. jean.mantz@bch.ap-hop-paris.fr
D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000628:therapy*; D003422:Critical Care; D004569:Electroencephalography / Q000187:drug effects*; D015600:Glasgow Coma Scale; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D012151:Resuscitation
D006993:Hypnotics and Sedatives