title: Responsiveness to stimuli of bispectral index, middle latency auditory evoked potentials and clinical scales in critically ill children.
abstract: We performed simultaneous recordings of Bispectral Index (BIS) and middle latency auditory evoked potentials. We also recorded two clinical scales, the Modified Ramsay scale and the COMFORT scale. Heart rate and blood pressure were measured once a day, for a maximum of 5 days, in 81 critically ill children. Changes with tactile, auditory, and painful stimuli were analysed. All the stimuli significantly increased the BIS value, the painful stimulus having the greatest effect. The painful stimulus was the only one that altered the middle latency auditory evoked potentials. Although the responses of the clinical scales to stimuli were statistically significant, they were of little clinical relevance. None of the stimuli used significantly altered the heart rate or blood pressure. We conclude that tactile, auditory and painful stimuli produced changes of little relevance in the clinical scales, BIS or middle latency auditory evoked potentials. We found the BIS was the most sensitive method and the painful stimulus had the greatest effect.
authors.affiliation: Pediatric Intensive Care Unit, Gregorio Marañón University General Hospital, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Lamas
authors.forename: J
authors.initials: J
authors.lastname: López-Herce
authors.forename: L
authors.initials: L
authors.lastname: Sancho
authors.forename: S
authors.initials: S
authors.lastname: Mencía
authors.forename: A
authors.initials: A
authors.lastname: Carrillo
authors.forename: M
authors.initials: M
authors.lastname: José Santiago
authors.forename: V
authors.initials: V
authors.lastname: Martínez
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000293:Adolescent; D001364:Awareness; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D004569:Electroencephalography; D005072:Evoked Potentials, Auditory; D005260:Female; D006339:Heart Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology; D010812:Physical Stimulation / Q000379:methods; D011446:Prospective Studies; D011930:Reaction Time; D012121:Respiration, Artificial
chemical_list: D009466:Neuromuscular Blocking Agents