Potential benefits of bispectral index monitoring in critical care. A case study.

To purchase reprints, contact The InnoVision Group, 101 Columbia, Aliso Viejo, CA 92656. Phone, (800) 8092273 or (949) 362-2050 (ext 532); fax, (949) 362-2049; e-mail, [email protected]. BIS monitors provide information clinically relevant to the adjustment of dosages of sedating medications. Use of a BIS monitor may affect overall costs of sedation in critically ill patients. BIS monitors are noninvasive devices that reflect a signal-processed electroencephalogram (EEG). They provide an index of the degree of sedation in patients receiving mechanical ventilation and sedative agents after surgery, trauma, or medical illness. BIS monitoring was first developed as an adjunctive method of monitoring anesthesia states during surgery. After 11 years of validation and utility testing of EEG waveform analysis algorithms, BIS monitors were developed by examining certain EEG features derived from power spectral and bispectral analysis, noting various end points for consciousness, and incorporating features that correlate best with the changes in the hypnotic state. DaiWai M. Olson, RN, BSN, CCRN Susan M. Chioffi, RN, MSN, ACNP, CCRN Gary E. Macy, RN, MSN, ACNP LorieAnn G. Meek, RN, CCRN Helen A. Cook, RN, MSN Bispectral index (BIS) monitoring is new to critical care. The following case presentation and narrative describe our experience with this technology. Although this article highlights the potential benefits of using this technology in the critical care setting, our intention is to stimulate research and discussion that will increase understanding of the benefits and limitations of using BIS monitors in critical care units.