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https://www.readbyqxmd.com/read/29464690/bis-monitoring-versus-clinical-assessment-for-sedation-in-mechanically-ventilated-adults-in-the-intensive-care-unit-and-its-impact-on-clinical-outcomes-and-resource-utilization
#1
REVIEW
Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam
BACKGROUND: Patients admitted to intensive care and on mechanical ventilation, are administered sedative and analgesic drugs to improve both their comfort and interaction with the ventilator. Optimizing sedation practice may reduce mortality, improve patient comfort and reduce cost. Current practice is to use scales or scores to assess depth of sedation based on clinical criteria such as consciousness, understanding and response to commands. However these are perceived as subjective assessment tools...
February 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29319461/hypnosis-is-more-effective-than-clinical-interviews
#2
Francisco Xavier De Almeida-Marques, José Sánchez-Blanco, Francisco Javier Cano-García
To determine whether hypnosis is more effective than conventional interviewing to find traumatic life events in patients with fibromyalgia, we carried out a within-subject experimental design with complete intragroup counterbalancing. Thirty-two women under care in a public primary care center gave 2 identical interviews, with an interval of 3 months, in which the occurrence of traumatic life events was explored, once in a state of wakefulness and once in a state of hypnosis. The state of consciousness was evaluated using 3 measures: bispectral index, skin conductance level, and pain intensity...
January 2018: International Journal of Clinical and Experimental Hypnosis
https://www.readbyqxmd.com/read/29284834/comparison-of-dexmedetomidine-and-midazolam-for-sedation-in-mechanically-ventilated-patients-guided-by-bispectral-index-and-sedation-agitation-scale
#3
Manoj Tripathi, Virendra Kumar, Mahendra B Kalashetty, Deepak Malviya, Prateek Singh Bais, Om Prakash Sanjeev
Background: Mechanical ventilation and sedation are inextricably linked components of critical care that represent, what we do for the patients during their vulnerable course in Intensive Care Unit (ICU). Aims: The aim of this study is to compare the efficacy and safety of midazolam and dexmedetomidine in patients on mechanical ventilator with the help of Bispectral Index (BIS) monitoring and correlation of BIS with Sedation-Agitation Scale (SAS). Settings and Design: Prospective, observational, and comparative study...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28946920/role-of-bispectral-index-monitoring-and-burst-suppression-in-prognostication-following-out-of-hospital-cardiac-arrest-a-systematic-review-protocol
#4
Leanne Eveson, Marcela Vizcaychipi, Shashank Patil
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is associated with significant mortality or may have a poor neurological outcome. Various community-training programmes have improved practices like bystander cardiopulmonary resuscitation (CPR) and early defibrillation using automated external defibrillator (AED). Post-resuscitation care has also changed significantly in the millennium. Interventions like targeted temperature management (TTM), avoidance of hyperoxia and emergency cardiac catheterisation have given patients a chance of a better neurological outcome...
September 25, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28844933/early-detection-of-brain-death-using-the-bispectral-index-bis-in-patients-treated-by-extracorporeal-cardiopulmonary-resuscitation-e-cpr-for-refractory-cardiac-arrest
#5
Romain Jouffroy, Lionel Lamhaut, Alexandra Guyard, Pascal Philippe, Kim An, Christian Spaulding, Frédéric Baud, Pierre Carli, Benoît Vivien
BACKGROUND: Despite increasing use of extracorporeal cardiopulmonary resuscitation (E-CPR) for treatment of refractory cardiac arrest patients, prognosis remains dismal, often resulting in brain-death. However, clinical assessment of brain-death occurence is difficult in post-cardiac arrest patients, sedated, paralyzed, under mild therapeutic hypothermia (MTH). Our objective was to assess the usefulness of Bispectral-Index (BIS) monitoring at bedside for an early detection of brain-death occurrence in refractory cardiac arrest patients treated by E-CPR...
November 2017: Resuscitation
https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#6
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28682828/criteria-for-intensive-care-admission-and-monitoring-after-elective-craniotomy
#7
Rafael Badenes, Lara Prisco, Armando Maruenda, Fabio S Taccone
PURPOSE OF REVIEW: The current article revises the recent evidence on ICU admission criteria and postoperative neuromonitoring for patients undergoing elective craniotomy. RECENT FINDINGS: Only a small proportion of elective postoperative neurosurgical patients require specific medical interventions and invasive monitoring. Among these, patients undergoing elective craniotomy are frequently admitted to neuro-ICU, specialist postanaesthesia care units or intermediate-level care unit in the postoperative period...
October 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28598913/xenon-as-an-adjuvant-to-propofol-anesthesia-in-patients-undergoing-off-pump-coronary-artery-bypass-graft-surgery-a-pragmatic-randomized-controlled-clinical-trial
#8
RANDOMIZED CONTROLLED TRIAL
Layth Al Tmimi, Sarah Devroe, Geertrui Dewinter, Marc Van de Velde, Gert Poortmans, Bart Meyns, Bart Meuris, Mark Coburn, Steffen Rex
BACKGROUND: Xenon was shown to cause less hemodynamic instability and reduce vasopressor needs during off-pump coronary artery bypass (OPCAB) surgery when compared with conventionally used anesthetics. As xenon exerts its organ protective properties even in subanesthetic concentrations, we hypothesized that in patients undergoing OPCAB surgery, 30% xenon added to general anesthesia with propofol results in superior hemodynamic stability when compared to anesthesia with propofol alone...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28591048/effects-of-dexmedetomidine-on-sleep-quality-of-patients-after-surgery-without-mechanical-ventilation-in-icu
#9
Weina Lu, Qinghui Fu, Xiaoqian Luo, Shuiqiao Fu, Kai Hu
Sleep quality of patients in intensive care unit (ICU) has been recently recognized as an important aspect of the intensive care. Dexmedetomidine is one of the most recently introduced for sedation in the ICU. This study was designed to evaluate the effect of dexmedetomidine on sleep quality of patients without mechanical ventilation in ICU.The patients who were included in this study were divided into two groups. In the sedation group, dexmedetomidine was given by a continuous infusion targeting a sedation level -1 to -2 on the score of RASS (Richmond Agitation-Sedation Scale)...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28543642/bidirectional-superior-cavopulmonary-anastomosis-with-or-without-cardiopulmonary-bypass-a-randomized-study
#10
RANDOMIZED CONTROLLED TRIAL
Sachin Talwar, Anish Gupta, Ashima Nehra, Neeti Makhija, Poonam Malhotra Kapoor, Vishnubhatla Sreenivas, Shiv Kumar Choudhary, Balram Airan
OBJECTIVES: This study aims to compare the bidirectional superior cavopulmonary anastomosis (BDG) with or without cardiopulmonary bypass (CPB). METHODS: 100 patients undergoing BDG were randomized into two groups: Off-CPB or on-CPB groups. All patients underwent near-infrared spectrophotometry (NIRS) and bispectral index (BIS) monitoring and pre- and postoperative serum 100 beta protein measurements (Sβ100) and neuro-cognitive evaluation. Postoperative intensive care unit (ICU) parameters were also studied...
June 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28315727/increasing-or-fluctuating-bispectral-index-values-during-post-resuscitation-targeted-temperature-management-can-predict-clinical-seizures-after-rewarming
#11
Kanae Ochiai, Atsushi Shiraishi, Yasuhiro Otomo, Yuuichi Koido, Takashi Kanemura, Masato Honma
AIM: To investigate whether an increasing bispectral index (BIS) value during targeted temperature management (TTM) correlates with increased clinical seizures after TTM or worse neurological prognoses after TTM. METHODS: We performed a retrospective prognostication study of patients who were treated with TTM after recovery of spontaneous circulation from cardiac arrest at a tertiary care hospital. We recorded the BIS regularly during TTM and calculated the correlations of the mean BIS values, standard deviations of the BIS values, and linear regression coefficient of the trend of the BIS values over time as index tests...
May 2017: Resuscitation
https://www.readbyqxmd.com/read/28044337/the-role-and-limitations-of-eeg-based-depth-of-anaesthesia-monitoring-in-theatres-and-intensive-care
#12
REVIEW
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
https://www.readbyqxmd.com/read/27850804/1167-a-comparison-of-the-bispectral-index-and-state-behavioral-scale-in-the-pediatric-intensive-care-unit
#13
Aaron Kessel, Todd Sweberg, Myriam Kline, James Schneider
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27755648/anaesthetic-interventions-for-prevention-of-awareness-during-surgery
#14
REVIEW
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
https://www.readbyqxmd.com/read/27499818/allogeneic-blood-product-usage-in-coronary-artery-bypass-grafting-cabg-with-minimalized-extracorporeal-circulation-system-mecc-versus-standard-on-pump-coronary-artery-bypass-grafting
#15
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
https://www.readbyqxmd.com/read/27398299/inadequate-sedation-during-therapeutic-paralysis-use-of-bispectral-index-in-critically-ill-patients
#16
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
https://www.readbyqxmd.com/read/26967259/interventions-for-preventing-delirium-in-hospitalised-non-icu-patients
#17
REVIEW
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
https://www.readbyqxmd.com/read/26615579/color-density-spectral-array-of-bilateral-bispectral-index-system-electroencephalographic-correlate-in-comatose-patients-with-nonconvulsive-status-epilepticus
#18
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
https://www.readbyqxmd.com/read/26393184/comparison-between-dexmedetomidine-and-propofol-with-validation-of-bispectral-index-for-sedation-in-mechanically-ventilated-intensive-care-patients
#19
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
https://www.readbyqxmd.com/read/26233335/mechanism-based-population-pharmacokinetic-and-pharmacodynamic-modeling-of-intravenous-and-intranasal-dexmedetomidine-in-healthy-subjects
#20
RANDOMIZED CONTROLLED TRIAL
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
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