The SNAP index does not correlate with the State Behavioral Scale in intubated and sedated children.
The SNAP index does not correlate with the State Behavioral Scale in intubated and sedated children.
复制标题
SNAP 指数与插管和镇静儿童的状态行为量表不相关。
DOI：
10.1111/pan.12258
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
GiulianoJr,JohnS
中科院分区：
文献类型：
--
作者：
Thompson,Cecilia;Shabanova,Veronika;GiulianoJr,JohnS
背景：确保对危重症患儿给予适当的镇静水平是儿科危重症护理不可或缺的一部分。传统上，临床医生使用主观评分工具来评估镇静水平。SNAP II使用双频处理脑电图来评估脑活动，并可能提供镇静水平的客观评估。目的探讨小儿危重症患者镇静的客观监测方法。我们将处理过的脑电图设备SNAP II与主观镇静评分工具状态行为量表（SBS）进行了比较。我们假设SNAP II与SBS相关，并且观察者偏差较小。方法：本研究为IRB批准的前瞻性观察性研究。接受机械通气静脉镇静的患者经知情同意入组。连接SNAP II监测电极后，盲法床边护士使用SBS评估镇静水平。收集SNAP指数并与SBS评分进行比较，以确定相关性。结果采用Pearson相关和最小二乘法比较15例患者的417对数据点，确定SBS与SNAP指标之间的相关性。没有观察到相关性。使用协方差模型模式进行重复测量来调整协变量再次显示没有相关性。结论小儿重症监护病房（PICU）患者SNAP指数与SBS评分无相关性。在我们的人群中，不建议使用它来测量镇静水平。今后的研究应继续探索危重患儿镇静作用的客观测量方法。
BackgroundEnsuring appropriate levels of sedation for critically ill children is integral to pediatric critical care. Traditionally, clinicians have used subjective scoring tools to assess sedation levels. The SNAP II uses dual frequency processed electroencephalography to evaluate brain activity and may provide an objective assessment of sedation levels.ObjectiveThis study attempts to find an objective method to monitor sedation in critically ill pediatric patients. We compared the SNAP II, a processed electroencephalography device, with the State Behavioral Scale (SBS), a subjective sedation scoring tool. We hypothesize that the SNAP II correlates with the SBS and has less observer bias.MethodsThis was an IRB approved prospective, observational study. Patients receiving intravenous sedation while being mechanically ventilated were enrolled after informed consent. After the SNAP II monitoring electrodes were attached, blinded bedside nurses assessed sedation levels using the SBS. SNAP indices were collected and compared with SBS scores to determine correlation.ResultsWe compared 417 paired data points from 15 patients using Pearson's correlation and least squares means to determine correlation between the SBS and SNAP indices. No correlation was observed. Using covariance model patterning for repeated measures to adjust for covariates again showed no correlation.ConclusionThe SNAP index does not correlate with SBS scores in our pediatric intensive care unit (PICU). Its use cannot be recommended to measure levels of sedation in our population. Future research should continue to explore objective ways of measuring sedation in critically ill children.