Bispectral analysis and motor activity assessment scores in mechanically ventilated patients in the intensive care unit.

摘要

Objectives. The purpose of this study is to determine the correlation between Motor Activity Assessment Scale (MAAS) and Bispectral Analysis (BIS) scores following a sedation protocol utilized for mechanically ventilated ICU patients.; Methods. After IRB approval, 30 adult mechanically ventilated ICU patients undergoing sedation protocol were enrolled in a descriptive, prospective, observational investigation. Surrogate consent was obtained. Repeated measures design was used with hourly MAAS and 750 blinded BIS values recorded simultaneously for a continuous 24-hour period. Hourly MAAS scores for this period were obtained from staff nurses' charting. Demographic data was also obtained from patients' clinical charts. Descriptive and correlation statistical approaches were used.; Results. The sample had a mean age of 63 +/− 16.32 years; 63% were male and 37% were female; 40% were medicine patients and 60% were surgical patients. For each MAAS group, an overall mean BIS was calculated. Linear regression determined that there was a strong (R2 = 0.93, p .0001) correlation between BIS and each MAAS group. Sub-group analysis of sedation practices between surgical (R2 = 0.93, p .0001) and medicine (R2 = 0.75, p .0001) groups demonstrated a difference between BIS and MAAS scores when evaluating under-sedation, ideal sedation and over-sedation. BIS scores were more accurate in determining sedation levels.; Conclusions. MAAS and BIS are effective tools for determining level of sedation in mechanically ventilated ICU patients. The correlation between subjective MAAS and objective BIS scales varied in medical and surgical patients with BIS being more accurate.