Impact of bispectral index monitoring on sedation and outcomes in critically ill adults: a case series.
In situations in which clinical assessment of sedation level is compromised, such as deep sedation/analgesia with and without neuromuscular blockade (NMB), electroencephalogram-based monitoring may potentially assist in achieving balance between inadequate and excessive levels of sedation. To validate the bispectral index (BIS) for use in clinical practice, correlation and possible differences in outcome using clinical assessment versus clinical assessment augmented by electroencephalogram-based monitoring were determined. BIS monitoring was decisive in ICU care in 9 of 15 patients in this series. The most significant potential benefit was obtained in the subset of patients receiving NMB.
Arbour
Richard
R
Albert Einstein Healthcare Network, 5501 Old York Road, Philadelphia, PA 19141-3211, USA. richnrs@aol.com
D000328:Adult; D000368:Aged; D015400:Clinical Nursing Research; D016292:Procedural Sedation / Q000009:adverse effects / Q000451:nursing; D003422:Critical Care / Q000379:methods* / Q000592:standards; D016903:Drug Monitoring / Q000379:methods* / Q000451:nursing / Q000592:standards; D004569:Electroencephalography / Q000379:methods* / Q000451:nursing / Q000592:standards; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods / Q000451:nursing / Q000592:standards; D019148:Neuromuscular Blockade; D009730:Nursing Assessment / Q000379:methods / Q000592:standards; D015403:Nursing Evaluation Research; D018579:Patient Selection; D012121:Respiration, Artificial / Q000009:adverse effects; D012815:Signal Processing, Computer-Assisted; D016896:Treatment Outcome