Friday December 2, 2005
BIS (Bispectral Index) monitoring
BIS monitoring is an underutilize tool in ICUs particularly in patients on paralytics. Experts are still debating its full value. General guide regarding BIS monitoring level, if use:
100 - 80: Awake or sedation is light
60 - 80: Respond to command but may not recall the event.
40 - 60: Probably sedation is optimum.
Less than 40: Deep sedation
0: No EEG like in barbiturate coma or deep hypothermia.
Key is to monitor BIS sedation scale with hemodynamics together as BIS doesn’t provide any measurement of analgesia which may be needed simultaneously with sedation.
References: click to get abstract/article
1. BIS Monitoring to Prevent Awareness during General Anesthesia - Anesthesiology: Volume 94(3) March 2001 pp 520-522
2. BIS monitoring in ICU: advantages of the new XP generation - Critical Care 2002, 6(Suppl 1):P68
3. Potential Benefits of Bispectral Index Monitoring in Critical Care: A Case Study - Crit Care Nurse 2003 Aug;23(4):45-52
4. Use of BIS Monitoring Was Not Associated with a Reduced Incidence of Awareness - Anesth Analg.2005; 100: 1221