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bispectral intensive care

Z Hajat, N Ahmad, J Andrzejowski
In this article we will look at some of the principles in processed EEG monitoring as applied to bispectral index (BIS). We outline why BIS should be regarded as a 'memory' monitor which in most circumstances reflects the depth of sedation or anaesthesia in particular patients. Its limitation in paralysed and non-paralysed patients must be understood in order for this monitor to be used safely. Finally, its emerging use in critical care will be explored.
January 2017: Anaesthesia
Aaron Kessel, Todd Sweberg, Myriam Kline, James Schneider
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Anthony G Messina, Michael Wang, Marshall J Ward, Chase C Wilker, Brett B Smith, Daniel P Vezina, Nathan Leon Pace
BACKGROUND: General anaesthesia is usually associated with unconsciousness. 'Awareness' is when patients have postoperative recall of events or experiences during surgery. 'Wakefulness' is when patients become conscious during surgery, but have no postoperative recollection of the period of consciousness. OBJECTIVES: To evaluate the efficacy of two types of anaesthetic interventions in reducing clinically significant awareness:- anaesthetic drug regimens; and- intraoperative anaesthetic depth monitors...
October 18, 2016: Cochrane Database of Systematic Reviews
M Lisy, E Schmid, J Kozok, P Rosenberger, U A Stock, G Kalender
AIM: Intraoperative allogeneic blood product transfusion (ABPT) in cardiac surgery is associated with worse overall outcome, including mortality. The objective of this study was to evaluate the ABPTs in minimalized extracorporeal cardiopulmonary (MECC(TM)) compared with standard open system on-pump coronary revascularization. METHODS: Data of 156 patients undergoing myocardial revascularization between September 2008 and September 2010 were reviewed. 83 patients were operated by the MECC technique and 73 were treated by standard extracorporeal circulation (sECC)...
2016: Open Cardiovascular Medicine Journal
Chelsea L Tasaka, Jeremiah J Duby, Komal Pandya, Machelle D Wilson, Kimberly A Hardin
BACKGROUND: Patients receiving therapeutic paralysis may experience inadequate sedation due to intrinsic limitations of behavioral sedation assessment. Bispectral index (BIS™) provides an objective measure of sedation; however, the role of BIS™ is not well defined in intensive care unit (ICU) patients on neuromuscular blocking agents (NMBA). OBJECTIVE: The aim of this study was to delineate the relationship between BIS™ and level of sedation for critically ill patients during therapeutic paralysis...
June 2016: Drugs—Real World Outcomes
Najma Siddiqi, Jennifer K Harrison, Andrew Clegg, Elizabeth A Teale, John Young, James Taylor, Samantha A Simpkins
BACKGROUND: Delirium is a common mental disorder, which is distressing and has serious adverse outcomes in hospitalised patients. Prevention of delirium is desirable from the perspective of patients and carers, and healthcare providers. It is currently unclear, however, whether interventions for preventing delirium are effective. OBJECTIVES: To assess the effectiveness of interventions for preventing delirium in hospitalised non-Intensive Care Unit (ICU) patients...
March 11, 2016: Cochrane Database of Systematic Reviews
Miguel A Hernández-Hernández, José L Fernández-Torre
PURPOSE: to describe the characteristics of the color density spectral array (CDSA) of bilateral bispectral index (b-BIS) monitoring system in patients with comatose nonconvulsive status epilepticus (NCSE). We hypothesized that CDSA could be helpful for monitoring NCSE in critically subjects if continuous EEG (cEEG) is not available. METHODS: we retrospectively analyzed comatose patients admitted to our neurological intensive care unit (NICU) from 2011 to 2014 with a diagnosis of definitive NCSE that underwent b-BIS monitoring for at least 24h to guide anesthetic sedation...
January 2016: Seizure: the Journal of the British Epilepsy Association
Bharat Paliwal, Pyush Rai, Manoj Kamal, Geeta Singariya, Madhu Singhal, Priyanka Gupta, Tanuja Trivedi, Dilip Singh Chouhan
BACKGROUND AND AIM: Sedation plays a pivotal role in the care of the critically ill patient. It is equally important to assess depth of sedation. The present study had been designed to compare dexmedetomidine and propofol for sedation in mechanically ventilated intensive care patients. It also intended to verify the clinical validity, reliability and applicability of objective assessment tool bispectral index (BIS) for monitoring sedation and observe for correlation with the commonly used subjective scale, Ramsay sedation score (RSS)...
July 2015: Journal of Clinical and Diagnostic Research: JCDR
Heedoo Yoo, Timo Iirola, Sanna Vilo, Tuula Manner, Riku Aantaa, Maria Lahtinen, Mika Scheinin, Klaus T Olkkola, William J Jusko
PURPOSE: Dexmedetomidine is an α2-adrenoceptor agonist used for perioperative and intensive care sedation. This study develops mechanism-based population pharmacokinetic-pharmacodynamic models for the cardiovascular and central nervous system (CNS) effects of intravenously (IV) and intranasally (IN) administered dexmedetomidine in healthy subjects. METHOD: Single doses of 84 μg of dexmedetomidine were given once IV and once IN to six healthy men. Plasma dexmedetomidine concentrations were measured for 10 h along with plasma concentrations of norepinephrine (NE) and epinephrine (E)...
October 2015: European Journal of Clinical Pharmacology
Martin Soehle, Alexander Dittmann, Richard K Ellerkmann, Georg Baumgarten, Christian Putensen, Ulf Guenther
BACKGROUND: Postoperative delirium (POD) occurs frequently after cardiac surgery and is associated with increased morbidity and mortality. We analysed whether perioperative bilateral BIS monitoring may detect abnormalities before the onset of POD in cardiac surgery patients. METHODS: In a prospective observational study, 81 patients undergoing cardiac surgery were included. Bilateral Bispectral Index (BIS)-monitoring was applied during the pre-, intra- and postoperative period, and BIS, EEG Asymmetry (ASYM), and Burst Suppression Ratio (BSR) were recorded...
April 28, 2015: BMC Anesthesiology
Wonjung Hwang, Jaemin Lee, Jihyun Park, Jin Joo
BACKGROUND: Total intravenous anesthesia (TIVA) is used widely in spinal surgery because inhalational anesthetics are known to decrease the amplitude of motor evoked potentials. Presently, dexmedetomidine is used as an adjuvant for propofol-based TIVA. We compared the effects of remifentanil and dexmedetomidine on pain intensity as well as the analgesic requirements after post-anesthesia care unit (PACU) discharge in patients undergoing spinal surgery. METHODS: Forty patients scheduled for posterior lumbar interbody fusion (PLIF) surgery under general anesthesia were enrolled...
2015: BMC Anesthesiology
Aymen N Naguib, Peter D Winch, Joseph D Tobias, Keith O Yeates, Yongjie Miao, Mark Galantowicz, Timothy M Hoffman
INTRODUCTION: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. MATERIALS AND METHODS: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1(st) year of life...
January 2015: Saudi Journal of Anaesthesia
Johannes Prottengeier, Andreas Moritz, Sebastian Heinrich, Christine Gall, Joachim Schmidt
INTRODUCTION: The critically-ill undergoing inter-hospital transfers commonly receive sedatives in continuation of their therapeutic regime or to facilitate a safe transfer shielded from external stressors. While sedation assessment is well established in critical care in general, there is only little data available relating to the special conditions during patient transport and their effect on patient sedation levels. The aim of this prospective study was to investigate the feasibility and relationship of clinical sedation assessment (Richmond Agitation-Sedation Scale (RASS)) and objective physiological monitoring (bispectral index (BIS)) during patient transfers in our Mobile-ICU...
2014: Critical Care: the Official Journal of the Critical Care Forum
Saeed Mahmood, Ashok Parchani, Ayman El-Menyar, Ahmad Zarour, Hassan Al-Thani, Rifat Latifi
BACKGROUND: Bispectral index (BIS) monitoring in multiple trauma patients has become a common practice in monitoring the sedation levels. We aimed to assess the utility of BIS in the trauma intensive care unit (ICU). METHODS: A prospective observational study was conducted in the trauma ICU at Hamad General Hospital in Qatar between 2011 and 2012. Patients were divided in two groups: Group I (without BIS monitoring) and Group II (with BIS monitoring). The depth of sedation was clinically evaluated with Ramsey Sedation Scale, changes in vital signs and Glasgow Coma Scale (GCS) level...
2014: Surgical Neurology International
Pascal Stammet, Olivier Collignon, Christophe Werer, Claude Sertznig, Yvan Devaux
AIM OF THE STUDY: To address the value of continuous monitoring of bispectral index (BIS) to predict neurological outcome after cardiac arrest. METHODS: In this prospective observational study in adult comatose patients treated by therapeutic hypothermia after cardiac arrest we measured bispectral index (BIS) during the first 24 hours of intensive care unit stay. A blinded neurological outcome assessment by cerebral performance category (CPC) was done 6 months after cardiac arrest...
December 2014: Resuscitation
Jennifer L Vance, Amy M Shanks, Derek T Woodrum
BACKGROUND: Fast track recovery is a care process goal after cardiac surgery. Intraoperative anesthetic depth may impact recovery, but the impact of brain monitoring on time to extubation and intensive care unit (ICU) length of stay after cardiac surgery has not been extensively studied. Our goal was to determine if BIS-guided anesthesia improves time to extubation compared to MAC-guided anesthesia in a cardiac surgery population. METHODS: In this secondary outcome analysis of a randomized controlled study, we analyzed 294 patients undergoing elective coronary bypass grafting, valve replacements, and bypass plus valve replacements at a single tertiary referral center between February 1, 2009 and April 30, 2010...
2014: BMC Anesthesiology
Ah-Reum Cho, Hae-Kyu Kim, Eun-A Lee, Dong-Hun Lee
A 54-year-old woman with a history of severe tracheal stenosis caused by papillary thyroid cancer with tracheal invasion was admitted for an elective surgery. A bilateral superficial cervical plexus block with 0.5 % ropivacaine 14 ml (7 ml per side) under dexmedetomidine sedation was performed, followed by tracheal dissection and endotracheal tube (ETT) insertion. The patient continued spontaneous respiration without any hypoxic event, and the bispectral index was maintained at a range of 50-80. After ETT insertion, a total thyroidectomy and tracheal resection with end-to-end anastomosis were performed under general anesthesia...
April 2015: Journal of Anesthesia
Lin Dou, Hong-Mei Gao, Ling Lu, Wen-Xiu Chang
BACKGROUND: The bispectral (BIS) index is a processed electroencephalogram (EEG) parameter with extensive validation and demonstrated clinical utility. The study aimed to investigate the correlation between the BIS index and the prognosis of patients with coma in the ICU. METHODS: A total of 208 patients with coma in the ICU were enrolled in this study. According to the BIS value, the patients were divided into four groups: group I, BIS value 0 to 20; group II, BIS value 21 to 40; group III, BIS value 41 to 60; and group IV, BIS value greater than 60...
2014: World Journal of Emergency Medicine
Gemma Robleda, Ferran Roche-Campo, Gerard Urrútia, Marta Navarro, Maria-Àngels Sendra, Ana Castillo, Ainhoa Rodríguez-Arias, Elena Juanes-Borrejo, Ignasi Gich, Jordi Mancebo, Josep-E Baños
AIM: To compare the effectiveness and safety of fentanyl with placebo as pre-emptive treatment for pain associated with turning in patients in intensive care units. BACKGROUND: Turning is frequently a painful procedure in this setting. Pre-emptive administration of supplementary analgesia may help decrease this pain. However, medical literature on pre-emptive analgesia in these patients is scarce. DESIGN: A randomized, double-blind, controlled clinical trial...
February 2015: Journal of Advanced Nursing
Robin Marie Coleman, Yannick Tousignant-Laflamme, Paul Ouellet, Élizabeth Parenteau-Goudreault, Jennifer Cogan, Patricia Bourgault
BACKGROUND: Pain assessment is an immense challenge for clinicians, especially in the context of the intensive care unit, where the patient is often unable to communicate verbally. Several methods of pain assessment have been proposed to assess pain in this environment. These include both behavioural observation scales and evaluation of physiological measurements such as heart rate and blood pressure. Although numerous validation studies pertaining to behavioural observation scales have been published, several limitations associated with using these measures for pain assessment remain...
January 2015: Pain Research & Management: the Journal of the Canadian Pain Society
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