Bispectral index correlates well with Richmond agitation sedation scale in mechanically ventilated critically ill patients

Karamchandani, Kunal; Rewari, Vimi; Trikha, Anjan; Batra, Ramesh

doi:10.1007/s00540-010-0915-4

Cited by 59 publications

(37 citation statements)

References 23 publications

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“…The BIS is an objective indicator in assessing brain arousal and it is used in sedation assessment of mechanical ventilation as well as general anesthesia. BIS is reported to be correlated to other sedation indicators19,20. This study was able to verify significant correlation among sedation indicators and BIS exhibited significant results as well.…”

Section: Discussionsupporting

confidence: 63%

The Significance of Sedation Control in Patients Receiving Mechanical Ventilation

et al. 2012

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BackgroundAdequate assessment and control of sedation play crucial roles in the proper performance of mechanical ventilation.MethodsA total of 30 patients with various pulmonary diseases were prospectively enrolled. The study population was randomized into two groups. The sedation assessment group (SAG) received active protocol-based control of sedation, and in the empiric control group (ECG), the sedation levels were empirically adjusted. Subsequently, daily interruption of sedation (DIS) was conducted in the SAG.ResultsIn the SAG, the dose of midazolam was significantly reduced by control of sedation (day 1, 1.3±0.5 µg/kg/min; day 2, 0.9±0.4 µg/kg/min; p<0.01), and was significantly lower than the ECG on day 2 (p<0.01). Likewise, on day 2, sedation levels were significantly lower in the SAG than in the ECG. Significant relationship was found between Ramsay sedation scale and Richmond agitation-sedation scale (RASS; rs=-0.57), Ramsay Sedation Scale and Bispectral Index (BIS; rs=0.77), and RASS and BIS (rs=-0.79). In 10 patients, who didn't require re-sedation after DIS, BIS showed the earliest and most significant changes among the sedation scales. Ventilatory parameters showed significant but less prominent changes, and hemodynamic parameters didn't show significant changes. No seriously adverse events ensued after the implementation of DIS.ConclusionActive assessment and control of sedation significantly reduced the dosage of sedatives in patients receiving mechanical ventilation. DIS, conducted in limited cases, suggested its potential efficacy and tolerability.

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Section: Discussionsupporting

confidence: 63%

The Significance of Sedation Control in Patients Receiving Mechanical Ventilation

et al. 2012

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“…In ICU, BIS use remains controversial because of the high level of variability of this parameter as described in our study (Figure 4), which led us to study the variation of this rather isolated value. Some authors have concluded that the most recent version of BIS—BIS XP—is useful in the ICU setting for assessing sedation [23], whereas others do not share this view [24]. The use of BIS monitoring to assess pain in our study could be criticized, but it was shown to be sensitive to nociceptive stimuli in critically ill, sedated patients [6,25].…”

Section: Discussionmentioning

confidence: 86%

Adjunctive remifentanil infusion in deeply sedated and paralyzed ICU patients during fiberoptic bronchoscopy procedure: a prospective, randomized, controlled study

et al. 2012

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BackgroundEven with an adequate pain assessment, critically ill patients under sedation experience pain during procedures in the intensive care unit (ICU). We evaluated the effects of adjunctive administration of Remifentanil, a short-acting drug, in deeply sedated patient on variation of Bispectral Index (BIS) during a fiberoptic bronchoscopy.MethodsA prospective, randomized, blinded, placebo-controlled study was conducted in 18-bed ICU. Patients needing a tracheal fibroscopy under deep sedation (midazolam (0.1 mg/kg per hour) fentanyl (4 μg/kg per hour)) and neuromuscular blocking (atracurium 0.5 mg/kg) were included in the study. A continuous monitoring of BIS, arterial pressure, and heart rate were realized before, during, and after the fiberoptic exam. An adjunctive continuous placebo or Remifentanil infusion was started just before the fiberoptic exam with a target effect-site concentration of 4 ng/ml using a Base Primea pump.ResultsMean arterial pressure and heart rates were comparable between the placebo and Remifentanil groups at all times of the procedure. We did not observe differences in the variation of BIS values between the two groups during procedure. We described no change in BIS values relative to the placebo group in this population.ConclusionsIn deeply sedated and paralyzed patients, receiving analgesic support based on a scale score an additional administration of short-acting analgesic drug, such as Remifentanil, seems not to be necessary for acute pain control.Trial registrationNCT00162591.

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“…BİS değerlendirme-si daha objektif bir yöntem olmasına ve BİS değer-lendirmeleri ile RASS değerlendirmeleri korele bulunmuştur. NIMV uygulanan hastalarda "bilinçli sedasyon" hedeflendiğinden BİS kullanımı yerine RASS değerlendirmesi maliyet açısından daha uygun olacaktır (19,20). Sedasyonun daha derin yapılması gerekli ise BİS ile hastaların takibi uygundur.…”

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Sedation during noninvasive mechanical ventilation

Yıldırım¹,

Kara²,

Ersoy

2016

Tuberk Toraks

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Bispectral index correlates well with Richmond agitation sedation scale in mechanically ventilated critically ill patients

Abstract: Our results illustrate that BIS correlates well with RASS when assessing the level of sedation in mechanically ventilated critically ill patients. BIS reliably differentiates inadequate from adequate sedation.

Cited by 59 publications

References 23 publications

The Significance of Sedation Control in Patients Receiving Mechanical Ventilation

The Significance of Sedation Control in Patients Receiving Mechanical Ventilation

Adjunctive remifentanil infusion in deeply sedated and paralyzed ICU patients during fiberoptic bronchoscopy procedure: a prospective, randomized, controlled study

Sedation during noninvasive mechanical ventilation

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