Role of bispectral index monitoring in Intensive Care Unit mechanical ventilation patients: a Meta-analysis

Abstract

Objective To use Meta-analysis to compare the roles of bispectral index (BIS) monitoring and subjective rating scale in Intensive Care Unit (ICU) mechanical ventilation patients, and to provide a reference for selecting better sedation assessment tools in clinical practice. Methods Randomized controlled trials in ICU mechanical ventilation patients were collected from Scopus, Web of Science, PubMed, CNKI, Cochrane Library, VIP, WanFang Date, and CBM from database establishing to 2018 by BIS monitoring. The literatures were selected according to inclusion and exclusion criteria, data were extracted and the quality of the trials was evaluated. Meta-analysis was performed using RevMan5 software. Results Eleven randomized controlled studies were screened out. The total sample had 1354 cases, including 664 in the BIS group and 690 in the subjective rating scale group. Meta-analysis showed that sedative drug use (standardized mean difference [SMD]=0.28, 95%CI:-0.20-0.76), duration of sedation (mean difference [MD]=0.84, 95%CI: 2.00-3.67), arousal time after discontinuation (MD=-6.20, 95%CI: 19.76-7.35), mechanical ventilation time (MD=-0.33, 95%CI:-1.20-0.54]), ICU hospitalization stay (MD=-0.82, 95%CI:-3.94-2.30), and mortality (odds ratio [OR]=0.83, 95%CI: 0.52-1.32) showed no significant differences between the two groups (P>0.05). The incidence of unplanned extubation in the BIS group (OR=0.20, 95% CI: 0.10-0.42) was significantly lower than that in the subjective rating scale group (P<0.05). Conclusion There is currently insufficient evidence to show that BIS monitoring is superior to subjective rating scale in sedative drug use and disease prognosis in ICU mechanical ventilation. Key words: Bispectral index; Subjective rating scale; Mechanical ventilation; Meta-analysis