Bispectral index correlates well with Richmond agitation sedation scale in mechanically ventilated critically ill patients
Bispectral index correlates well with Richmond agitation sedation scale in mechanically ventilated critically ill patients
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DOI：
10.1007/s00540-010-0915-4
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发表时间：
2010-06-01
影响因子：
2.8
通讯作者：
Batra, Ravinder Kumar
中科院分区：
文献类型：
--
作者：
Karamchandani, Kunal;Rewari, Vimi;Batra, Ravinder Kumar
可用于评估重症监护室（ICU）镇静的临床镇静评分存在缺陷，并限制了其对瘫痪和深度镇静患者的有用性。在这种情况下，一个客观的工具，脑电双频指数（BIS），可以证明是有益的。我们评估了BIS评估ICU镇静水平的能力及其与里士满激动镇静量表（RASS）的相关性。24例机械通气的危重患者，年龄15-65岁，性别不限，研究时间为24 h。他们接受了标准的镇静方案，包括丙泊酚0.5 mg/kg和芬太尼1 μ g/kg的推注剂量，然后分别输注丙泊酚和芬太尼1.5 - 5 mg/kg/h和0.5 - 2.0 μ g/kg/h。记录血流动力学参数、体温、呼气末二氧化碳浓度、BIS和RASS值。BIS与RASS的相关性用Kendall相关系数（tau）表示。p值< 0.05被认为具有统计学显著性。共获得414个读数。在比较所有患者的BIS值与相应的RASS值时，两者之间存在统计学高度显著相关性。(tau= 0.56，p < 0.0001）。对于通过0至-3的RASS值判断的充分镇静，发现中位BIS值为56（范围42-89）。BIS值为70具有较高的敏感性（85%）和特异性（80%），以区分充分和不充分的镇静。我们的研究结果表明，BIS相关性以及与RASS评估机械通气危重患者的镇静水平。BIS可靠地区分镇静不足和充分。
The clinical sedation scores available for assessing sedation in the intensive care unit (ICU) have drawbacks and limit their usefulness in paralyzed and deeply sedated patients. An objective tool, the bispectral index (BIS), could prove beneficial in such circumstances. We evaluated the ability of BIS to assess the level of sedation and its correlation with the Richmond agitation sedation scale (RASS) in ICU.Twenty-four, mechanically ventilated, critically ill patients of either sex, 15-65 years of age, were studied over a period of 24 h. They received a standard sedation regimen consisting of a bolus dose of propofol 0.5 mg/kg and fentanyl 1 mu g/kg followed by infusions of propofol and fentanyl ranging from 1.5 to 5 mg/kg/h and 0.5 to 2.0 mu g/kg/h, respectively. Hemodynamic parameters, temperature, end-tidal carbon dioxide, BIS and RASS values were recorded. The correlation of BIS and RASS was expressed as Kendall correlation coefficients (tau). A p value of < 0.05 was considered statistically significant.A total of 414 readings was obtained. On comparing BIS values for all patients with the corresponding RASS values, there was a statistically highly significant correlation between the two. (tau = 0.56, p < 0.0001). For adequate sedation as judged by a RASS value of 0 to -3, the median BIS value was found to be 56 (range 42-89). A BIS value of 70 had a high sensitivity (85%) and specificity (80%) to differentiate adequate from inadequate sedation.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.