Is the bispectral index appropriate for monitoring the sedation level of mechanically ventilated surgical ICU patients?

Abstract

BIS is correlated only in some ICU patients with the clinical assessment of their sedation level as based on various scores. At deeper sedation levels the interindividual differences increase. There were no criteria found to distinguish patients with and without correlation. This suggests that the BIS is not suitable for monitoring the sedation in a heterogeneous group of surgical ICU patients.

Correlation between the Sedation-Agitation Scale and the Bispectral Index in ventilated patients in the intensive care unit

“…[22][23][24] Subsequent studies have had much more varied results. Le Blanc et al, 25 Weatherburn et al, 26 Nasraway et al, 27 Chisholm et al, 28 Frenzel et al, 29 Vivien et al, 30 and Tonner et al 31 all concluded that BIS monitoring was not helpful for patients in the ICU. Arbour 32 and Bader and Arbour 33 suggested that more studies are needed.…”

Bispectral Index Monitoring in the Management of Sedation in an Intensive Care Unit Patient With Locked-in Syndrome

“…Current evidence does not support its routine use in a heterogeneous population of critically ill patients, because electromyography contributes heavily to BIS scores in nonparalyzed patients and results in large variations in data as well as frequent overestimation of the arousal state. [10][11][12] Accordingly, the concomitant use of muscle relaxants improves the reliability of BIS scores in nonparalyzed patients. 13,14 However, recent evidence [15][16][17] suggests that BIS scores may have acceptable diagnostic, prognostic, and therapeutic value specifically in the management of brain-injured and/or comatose patients.…”

Nouveaux outils de neuromonitorage

“…Néan-moins, les coefficients de corrélation sont très faibles, ce qui atténue la pertinence clinique des résultats, et il existe une grande dispersion des valeurs pour un même niveau de sédation. Des données contradictoires ont montré une mauvaise corrélation entre BIS et scores cliniques de sédation [90]. La corrélation BIS/score de sédation clinique serait meilleure chez les patients ne présentant pas d'activité musculaire [91] …”