Assessing the predictive value of the bispectral index vs patient state index on clinical assessment of sedation in postoperative cardiac surgery patients.
نویسندگان
چکیده
PURPOSE To compare the depth of sedation determined by Ramsay sedation scale (RSS) with electroencephalogram-based bispectral index (BIS) and patient state index (PSI). MATERIALS AND METHODS Fifty mechanically ventilated cardiac surgical patients undergoing propofol and morphine sedation were assessed hourly for up to 6 hours or until tracheal extubation using the BIS, PSI, and RSS. Correlation between RSS, BIS, and PSI was determined, as well as the interrater reliability of RSS, BIS, and PSI. kappa statistics was used to further evaluate the agreement between BIS and PSI. RESULTS There was positive correlation between BIS and PSI values (rho = 0.731, P < .001). The average weighted kappa coefficient was .40 between the BIS and PSI, 0.28 between the RSS and BIS, and 0.16 between the RSS and PSI. Intraclass correlation was consistently higher between the BIS and PSI at all time intervals during the study. Logistic regression modeling over study duration showed that the BIS was consistently better at predicting oversedation (area under the curve, 0.92) than the PSI (area under the curve, 0.78). A comparison of BIS and PSI receiver operating characteristic curves showed that the BIS monitor was a better predictor of oversedation compared with the PSI (P = .02). CONCLUSIONS There is significant positive correlation between the BIS and PSI but poor correlation and poor test agreement between the RSS and BIS as well as RSS and PSI. The BIS is a better predictor of oversedation compared with the PSI. There was no significant difference between the BIS and PSI with respect to the prediction of undersedation.
منابع مشابه
تاثیر سن بالا بر روی شاخص دو طیفی (Bispectral Index) قبل و بعد از تزریق آرامبخش: یک مطالعه آیندهنگر
Background: The Bispectral Index (BIS) is an EEG-derived value that measures the sedative and hypnotic component of the anesthetic state. The effects of age on the bispectral index have not been well documented. The objective of the present study was to determine the influence of age on hypnotic requirement and bispectral index in awake and in patients with sedation induced by midazolam.Methods...
متن کاملPerformance of the A-line Autoregressive Index (AAI) and of the Bispectral Index (BIS) at assessing depth of short-term sedation following cardiac surgery.
This study evaluated the correlation and agreement between the Bispectral Index (BIS) or A-line Autoregressive Index (AAI) and a clinical scoring system, the Ramsay Sedation Scale (RSS), in 40 patients after elective cardiac surgery and admission to the intensive care unit. All patients received sedation with propofol according to the study protocol. BIS, AAI and RSS were documented at two diff...
متن کاملمزایای مانیتورینگ Bispecteral index در افراد چاق کاندید کولهسیستکتومی لاپاراسکوپیک در بیهوشی با ایزوفلوران
Background: Morbid obesity is associated with a some of significant comorbidities. Early and uneventful postoperative recovery of obese patients remains a challenge for anesthesiologists. It seems Bispecteral Index (BIS) monitoring may reduce drug usage and hasten recovery time in inhalation anesthesia. The aim of this study was to investigate the effect of BIS monitoring on intraoperative isof...
متن کاملImpact of Bispectral Index Monitoring Versus Clinical Judgment as a Guide for Conduction of Anesthesia on Serum Cortisol Level in Co-ronary Artery Bypass Graft Surgery
Background: Inadequate depth of anesthesia leads to release of stress hormones. Electroencephalographic monitoring by bispectral index is a guide to asses the depth of anesthesia. The aim of the present study was to measure the serum cortisol levels as an index of stress response in patients who are candidates for coronary artery bypass graft surgery in two groups of patients. Methods: Seventy-...
متن کاملBlocking noise but not music lowers bispectral index scores during sedation in noisy operating rooms.
STUDY OBJECTIVE To determine whether playing music or blocking noise can reduce bispectral index (BIS) values during propofol sedation. DESIGN Prospective, randomized, single-blinded study. SETTING Operating room. PATIENTS 63 ASA physical status I and II patients, aged 55 to 75 years, undergoing total knee replacement. INTERVENTIONS Patients were divided into three groups: noise, silenc...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of critical care
دوره 24 3 شماره
صفحات -
تاریخ انتشار 2009