PDF(Pubmed)
Abstract：
UNASSIGNED: Severe traumatic brain injury affects ∼4500 per year across the UK. Most patients undergo a period of sedation to prevent secondary brain injury, however the optimal sedation target is unclear. This study aimed to assess the relationship between the electroencephalogram (EEG)-based Bispectral Index™ (BIS™) value and the clinical sedation score, along with other clinical outcomes.
UNASSIGNED: Patients with severe traumatic brain injury in four UK ICUs were recruited to have blinded BIS data collected for a 24-h period while sedated on the ICU. Drug, physiological, and outcome data were recorded from the ICU record. Sedation management was at the discretion of the ICU clinical team.
UNASSIGNED: Twenty-six participants were recruited to the study. The mean BIS was 38 (inter-quartile range 29-44) and there was poor correlation between BIS and sedation score as a group (correlation coefficient 0.17, 95% confidence interval 0.08-0.26), however the spread in BIS values increased with decreasing sedation score. There was no statistically significant relationship between BIS and intracranial pressure, vasopressor use, osmotherapy use, or need for an additional sedative.
UNASSIGNED: This study supports previous work showing that BIS decreases with decreasing sedation score. However, the variation in BIS values increased with deeper levels of clinical sedation. Patients may not be benefiting from the full potential of sedation in traumatic brain injury and further studies of sedation titrated to an EEG-based parameter are needed.
UNASSIGNED: NCT03575169.
UNASSIGNED: Patients with severe traumatic brain injury in four UK ICUs were recruited to have blinded BIS data collected for a 24-h period while sedated on the ICU. Drug, physiological, and outcome data were recorded from the ICU record. Sedation management was at the discretion of the ICU clinical team.
UNASSIGNED: Twenty-six participants were recruited to the study. The mean BIS was 38 (inter-quartile range 29-44) and there was poor correlation between BIS and sedation score as a group (correlation coefficient 0.17, 95% confidence interval 0.08-0.26), however the spread in BIS values increased with decreasing sedation score. There was no statistically significant relationship between BIS and intracranial pressure, vasopressor use, osmotherapy use, or need for an additional sedative.
UNASSIGNED: This study supports previous work showing that BIS decreases with decreasing sedation score. However, the variation in BIS values increased with deeper levels of clinical sedation. Patients may not be benefiting from the full potential of sedation in traumatic brain injury and further studies of sedation titrated to an EEG-based parameter are needed.
UNASSIGNED: NCT03575169.
摘要：
■在英国，严重的创伤性脑损伤每年影响4500人。大多数患者都要经过一段时间的镇静治疗，以防止继发性脑损伤，然而,最佳镇静目标尚不清楚.本研究旨在评估基于脑电图（EEG）的双频指数（BIS™）值与临床镇静评分之间的关系，以及其他临床结果。
■在四个英国ICU中的严重创伤性脑损伤患者被招募，以在ICU镇静期间收集24小时的BIS数据。药物，生理,和结果数据从ICU记录中记录.镇静管理由ICU临床团队自行决定。
■招募了26名参与者。平均BIS为38（四分位数范围29-44），并且BIS与镇静评分之间的相关性较差（相关系数0.17，95％置信区间0.08-0.26），然而,BIS值的传播随着镇静评分的降低而增加.BIS与颅内压之间无统计学意义的关系，血管加压药的使用,渗透疗法的使用，或者需要额外的镇静剂。
■这项研究支持先前的工作，表明BIS随镇静评分的降低而降低。然而,BIS值的变化随着临床镇静水平的加深而增加.患者可能无法从创伤性脑损伤中镇静的全部潜力中受益，需要进一步研究根据基于EEG的参数滴定的镇静作用。
■NCT03575169。
■在四个英国ICU中的严重创伤性脑损伤患者被招募，以在ICU镇静期间收集24小时的BIS数据。药物，生理,和结果数据从ICU记录中记录.镇静管理由ICU临床团队自行决定。
■招募了26名参与者。平均BIS为38（四分位数范围29-44），并且BIS与镇静评分之间的相关性较差（相关系数0.17，95％置信区间0.08-0.26），然而,BIS值的传播随着镇静评分的降低而增加.BIS与颅内压之间无统计学意义的关系，血管加压药的使用,渗透疗法的使用，或者需要额外的镇静剂。
■这项研究支持先前的工作，表明BIS随镇静评分的降低而降低。然而,BIS值的变化随着临床镇静水平的加深而增加.患者可能无法从创伤性脑损伤中镇静的全部潜力中受益，需要进一步研究根据基于EEG的参数滴定的镇静作用。
■NCT03575169。
