Abstract
The bispectral index (BIS) is a processed neurophysiological electroencephalographic parameter that may be used to evaluate the depth of sedation in critically ill children. Triltsch and colleagues attempted to correlate BIS scores with a commonly used clinical sedation scoring system. They were able to demonstrate good correlation during deep sedation and in cases where the electrical impedance of the BIS electrodes was lowest. Studies have shown only moderate degrees of correlation between BIS scores and clinical sedation scoring systems. There is currently insufficient evidence to recommend routine monitoring of BIS scores in critically ill children.
Highlights
Neurophysiological, paediatric intensive care unit, sedation. In this issue of Critical Care, Triltsch and colleagues [1] report on the use of the bispectral index (BIS) as a monitor of sedation in the paediatric intensive care unit (PICU)
The median duration of endotracheal intubation in a noncardiac PICU would typically be in region of 3–4 days, and the utility of BIS as a measure of sedation in critically ill children would have to be assessed during the entire period of sedation rather than just focusing on the first few hours
It must be remembered that the optimal range of BIS scores for varying depths of sedation remain poorly defined and are subject to great variability between patients
Summary
In this issue of Critical Care, Triltsch and colleagues [1] report on the use of the bispectral index (BIS) as a monitor of sedation in the paediatric intensive care unit (PICU). They attempted to correlate BIS scores with the COMFORT score – a commonly used clinical sedation scoring system. The stated aim was to determine whether BIS is a useful tool for assessing the level of sedation in critically ill children.
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