Perspectives on sedation assessment in critical care.
Multiple studies have been undertaken to show that neurofunction monitors can correlate to objective sedation assessments. Showing a correlation between these 2 patient assessments tools may not be the correct approach for validation of neurofunction monitors. Two different methods of assessing 2 different modes of the patient's response to sedation should not be expected to precisely correlate unless the desire is to replace one method with the other. We provide a brief summary of several sedation scales, physiologic measures and neurofunction monitoring tools, and correlations literature for bispectral index monitoring, and the Ramsay Scale and the Sedation Agitation Scale. Neurofunction monitors provide near continuous information about a different domain of the sedation response than intermittent observational assessments. Further research should focus on contributions from this technology to the improvement of patient outcomes when neurofunction monitoring is used as a complement, not a replacement, for observational methods of sedation assessment.
Olson
Daiwai M
DM
School of Nursing, The University of North Carolina at Chapel Hill, USA. dmOlson@email.unc.edu
Thoyre
Suzanne M
SM
Auyong
David B
DB
D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods / Q000451:nursing*; D003243:Consciousness / Q000187:drug effects; D003422:Critical Care / Q000379:methods; D016903:Drug Monitoring / Q000295:instrumentation / Q000379:methods* / Q000451:nursing; D004569:Electroencephalography / Q000187:drug effects; D005072:Evoked Potentials, Auditory / Q000187:drug effects; D015600:Glasgow Coma Scale; D006801:Humans; D009043:Motor Activity / Q000187:drug effects; D009460:Neurologic Examination / Q000295:instrumentation / Q000379:methods* / Q000451:nursing; D009730:Nursing Assessment / Q000379:methods*; D015403:Nursing Evaluation Research; D017410:Practice Guidelines as Topic; D011594:Psychometrics; D011595:Psychomotor Agitation / Q000517:prevention & control; D015203:Reproducibility of Results; D012890:Sleep / Q000187:drug effects