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bis monitoring in picu

Sharon J Hawks, Debra Brandon, Tammy Uhl
BACKGROUND: Reliability of clinical scales and haemodynamic variables for assessing sedation depth in critically children is limited, particularly for those receiving neuromuscular blocking agents (NMBAs). OBJECTIVE: To introduce and integrate the use of Bispectral Index (BIS) monitoring as adjunct to sedation scale assessment in intubated mechanically ventilated Paediatric Intensive Care Unit (PICU) patients. METHODS: Quality improvement intervention including: BIS education for all PICU nurses; 8-week implementation of BIS monitoring guided by Paediatric BIS Sedation Protocol; evaluation by convenience sample of nurses (n=17)...
February 2013: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Carmelo Minardi, Emre Sahillioğlu, Marinella Astuto, Marco Colombo, Pablo Mauricio Ingelmo
Almost all children in the pediatric intensive care (PICU) need analgesia and/or sedation. Analgesics drugs are used to control pain from surgical incisions, drainages, vascular access or endotracheal suctioning. Sedatives are used to facilitate the delivery of nursing care, to facilitate mechanical ventilation, prevent self-extubation and to minimize patient discomfort. A therapeutic plan for analgesia and sedation should be established for each patient and regularly reviewed. The most often used sedation agents in PICU patients are Morphine or Fentanyl alone or in combination with Midazolam...
June 2012: Current Drug Targets
J L Vázquez Martínez
No abstract text is available yet for this article.
March 2012: Minerva Anestesiologica
A Amigoni, E Mozzo, L Brugnaro, C Gentilomo, V Stritoni, E Michelin, A Pettenazzo
BACKGROUND: The aim of this paper was to monitor comfort in pediatric critical ill patients which is necessary to adequate analgesic and sedative therapy. The primary objective of this prospective observational study was to measure the level of sedation in a Pediatric Intensive Care Unit (PICU) of a tertiary care Hospital, using Comfort Behavioural Scale (CBS) and Bispectral Index (BIS), evaluating the agreement between these tools; secondly we analyzed the correlation of an adequate level of sedation and patient's outcome...
March 2012: Minerva Anestesiologica
S Mencía, M Botrán, J López-Herce, J del Castillo et al.
OBJECTIVE: The aim of the study was to define the strategies for the use and monitoring of sedative, analgesic, and muscle relaxant medication in Spanish paediatric intensive care units (PICU). MATERIAL AND METHODS: A questionnaire with 102 questions was sent by e-mail to all Spanish PICUs. RESULTS: Replies were received from 36 of the 45 PICUs (80%). A written protocol for sedation and analgesia was used in 64%; this medication was adjusted according to the diagnosis and clinical status of the patient in 30% of the units...
June 2011: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
S R Froom, C A Malan, J S Mecklenburgh, M Price, M S Chawathe, J E Hall, N Goodwin
BACKGROUND: The Bispectral Index (BIS) monitor has been suggested as a potential tool to measure depth of sedation in paediatric intensive care unit (PICU) patients. The primary aim of our observational study was to assess the difference in BIS values between the left and right sides of the brain. Secondary aims were to compare BIS and COMFORT score and to assess change in BIS with tracheal suctioning. METHODS: Nineteen ventilated and sedated PICU patients had paediatric BIS sensors applied to either side of their forehead...
May 2008: British Journal of Anaesthesia
Debbie Long, Desley Horn, Samantha Keogh
INTRODUCTION: A retrospective analysis of sedation management for children receiving prolonged ventilation in one Australian paediatric intensive care unit (PICU) revealed no identifiable pattern in sedation management and an inadequacy in the sedation scoring system. Therefore, the investigators sought to explore the current practice of sedation in critically ill children in PICUs across Australia and New Zealand. METHOD: This study used a mail-out survey to audit sedation management within the eight dedicated Australian and New Zealand PICUs...
November 2005: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Troy E Dominguez, Mark A Helfaer
OBJECTIVES: Sedation is a key component in the management of pediatric patients both in the pediatric emergency department (PED) and pediatric intensive care unit (PICU) for the treatment of pain and anxiety. Bispectral (BIS) index monitoring has been developed to help clinicians assess degree of hypnosis with anesthesia and may be useful in these environments. METHODS: Literature searches were conducted through MEDLINE for case series/reports, retrospective studies, and randomized trials that evaluate the validity and applications of BIS monitoring in the PED and PICU...
December 2006: Pediatric Emergency Care
S Mencía Bartolomé, J López-Herce Cid, A Lamas Ferreiro, R Borrego Domínguez, L Sancho Pérez, A Carrillo Alvarez
The Bispectral Index (BIS) is a single numeric value that indicates the depth of hypnosis by estimating the level of electrical activity in the brain through analysis of the frequency bands in the electroencephalogram. The BIS was primarily developed to monitor the level of hypnosis during surgery and has recently begun to be used in critically-ill patients. Currently, there is little experience of the BIS in critically-ill children. We present 6 cases that illustrate the utility of BIS monitoring in the PICU...
January 2006: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Mark D Twite, Jeannie Zuk, Jane Gralla, Robert H Friesen
OBJECTIVE: The COMFORT scale is a commonly used observational scoring system to assess the level of sedation in ventilated children in pediatric intensive care units (PICUs). The bispectral index (BIS) monitor is a processed electroencephalographic parameter that noninvasively measures the hypnotic effect of anesthetic and sedative drugs on the brain. The objective of this study was to assess the degree of correlation between the COMFORT scale and the BIS monitor. DESIGN: A prospective study in a tertiary level PICU...
November 2005: Pediatric Critical Care Medicine
Andreas E Triltsch, Grit Nestmann, Helmut Orawa, Maryam Moshirzadeh, Michael Sander, Joachim Grosse, Arka Genähr, Wolfgang Konertz, Claudia D Spies
INTRODUCTION: Most clinicians give sedatives and analgesics according to their professional experience and the patient's estimated need for sedation. However, this approach is prone to error. Inadequate monitoring of sedation and analgesia may contribute to adverse outcomes and complications. With this in mind, data obtained continuously using nonstimulating methods such as bispectral index (BIS) may have benefits in comparison with clinical monitoring of sedation. The aim of this prospective observational trial was to evaluate the use of electroencephalographic (EEG) BIS for monitoring sedation in paediatric intensive care unit (PICU) patients...
February 2005: Critical Care: the Official Journal of the Critical Care Forum
John W Berkenbosch, Christopher R Fichter, Joseph D Tobias
UNLABELLED: In patients who are mechanically ventilated in the pediatric intensive care unit (PICU), sedative and/or analgesic medications are routinely provided and titrated to effect based on clinical assessment of the patient. The bispectral index (BIS) monitor uses a modified electroencephalogram to quantify the effects of central nervous system-acting drugs on the level of consciousness. To evaluate the usefulness of the BIS monitor to predict clinical sedation levels in the PICU, we compared BIS values with simultaneously obtained clinical sedation scores in 24 mechanically ventilated pediatric patients aged 5...
March 2002: Anesthesia and Analgesia
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