Correlación entre análisis biespectral y escala COMFORT en la evaluación de sedación en la Unidad de Cuidados Intensivos Pediátricos

Abstract

Bispectral index and COMFORT scale melation in the evaluation of sedation on Paediatrics intensive Care Units Background: Sedation of critically – ill children in Paediatrics Intensive Care Units (PICU) is an essential component of patient care. The Bispectral Index (BIS) is a non-invasive electroencephalographic technique that measures continuously the hypnotic effects of various sedative agents. Objective: Evaluate Bispectral Index technology on ventilated patients in PICU and determine the degree of correlation with COMFORT Scale. Method: Prospective – blinded – observational study, where sedate children were evaluated in their sedation level by using BIS monitor and COMFORT Scale. BIS values were categorized in very deep ( 80) levels of sedation. Results: 9 patients were enrolled in the study, obtaining 180 valid-paired observations of BIS values and COMFORT Scale scores. The median COMFORT Scale and BIS values were 17 (range 11-29) and 48 (range 18-90), respectively. The correlation coefficient between BIS and COMFORT Scale in the individual measurements was good (R = 0.74). When BIS measurements were categorized in light, moderate, deep and very deep sedation levels, the BIS and COMFORT Scale measurements were highly correlated (R = 0.92). 72% of BIS observations were above adequate sedation levels. Conclusions: There is a good correlation between BIS and COMFORT Scale. BIS may be a useful tool in sedation assessment on ventilated paediatric patients, identifying excessive sedation in PICU. (Key words: Bispectral Index, Paediatrics Intensive Care Unit, sedation). Rev Chil Pediatr 2007; 78 (6): 592-598