Critical Care

Until now, sedation assessment has been primarily guided by vital signs or subjective sedation assessment scales. These approaches may not be sufficient to achieve optimal patient assessment.

• More than 69% of patients in an ICU found to be inappropriately sedated

How BIS Works:

• Raw EEG information is obtained via a sensor placed on patient's forehead
• The BIS system processes the EEG information and calculates a number between 0 and 100 that provides a direct measure of the patient's level of consciousness and response to sedation
• A BIS value near 100 indicates the patient is fully awake
• A BIS value of zero indicates the absence of brain activity
• Sedatives may be titrated to a variety of BIS values depending on the goals for each patient
• Publications demonstrate that BIS works well as a measure
  of hypnotic drug effect in the ICU (1,2,3)

Improving care and contributing to cost savings in the ICU:

• Spectrum Health reduced average monthly costs of sedatives
• Medical College of Pennsylvania Hospital decreased their cost of sedative drugs
• Medical College of Pennsylvania Hospital reduced recall of unpleasant experiences
• Duke University, Durham, NC study: BIS use reduces drug costs while maintaining adequate sedation levels
  

References:

1. Simmons L, Riker R, Prato S, et al. Assessing sedation during intensive care unit mechanical ventilation with the Bispectral Index and the Sedation-Agitation Scale. Crit Care Med. 1999;27(8):1499-1504.
2. Triltsch A, Spies C, Lenhart A, et al. Bispectral Index (BIS) correlates with Ramsay Sedation Scores in Neurosurgical ICU Patients. Anesthesiology. 1999;91(3A):A295.
3. Shah N, Clack S, Chea F, et al. Can Bispectral Indes (BIS) of EEG be useful in assessing sedation in ICU patients? Anesth Analg. 1996;82:S400.