Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2005 Feb;9(1):R9-17.
doi: 10.1186/cc2977. Epub 2004 Nov 10.

Bispectral index versus COMFORT score to determine the level of sedation in paediatric intensive care unit patients: a prospective study

Andreas E Triltsch  1 , Grit Nestmann, Helmut Orawa, Maryam Moshirzadeh, Michael Sander, Joachim Grosse, Arka Genähr, Wolfgang Konertz, Claudia D Spies
Affiliations
Clinical Trial

Bispectral index versus COMFORT score to determine the level of sedation in paediatric intensive care unit patients: a prospective study

Andreas E Triltsch et al. Crit Care. 2005 Feb.

Erratum in

  • Crit Care. 2005 Oct 5;9(5):426

Abstract

Introduction: Most clinicians give sedatives and analgesics according to their professional experience and the patient's estimated need for sedation. However, this approach is prone to error. Inadequate monitoring of sedation and analgesia may contribute to adverse outcomes and complications. With this in mind, data obtained continuously using nonstimulating methods such as bispectral index (BIS) may have benefits in comparison with clinical monitoring of sedation. The aim of this prospective observational trial was to evaluate the use of electroencephalographic (EEG) BIS for monitoring sedation in paediatric intensive care unit (PICU) patients.

Methods: Forty paediatric patients (<18 years) were sedated for mechanical ventilation in a cardiac surgical and general PICU. In each paediatric patient BIS and COMFORT score were obtained. The study protocol did not influence ongoing PICU therapy. BIS and corresponding COMFORT score were collected three times for each patient. Measurements with the best starting EEG impedances were analyzed further. Deep sedation was defined as a COMFORT score between 8 and 16, and light sedation as a score between 17 and 26. Biometric and physiological data, and Pediatric Risk of Mortality III scores were also recorded.

Results: There was a good correlation (Spearman's rho 0.651; P = 0.001) between BIS and COMFORT score in the presence of deep sedation and low starting impedance. Receiver operating characteristic (ROC) analysis revealed best discrimination between deep and light sedation at a BIS level of 83.

Conclusion: In the presence of deep sedation, BIS correlated satisfactorily with COMFORT score results if low EEG impedances were guaranteed.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study design. BIS, bispectral index; PICU, paediatric intensive care unit.
Figure 2
Figure 2
Correlation of bispectral index (BIS) and COMFORT score at different levels of sedation.
Figure 3
Figure 3
Receiver operating characteristic (ROC) analysis: cut-off point between light and deep sedation. BIS, bispectral index.
Figure 4
Figure 4
Correlation of bispectral index (BIS) and COMFORT score in patients younger and older than 6 months.
See this image and copyright information in PMC

Comment in

References

    1. Tobias JD. Tolerance, withdrawal, and physical dependency after long-term sedation and analgesia of children in pediatric intensive care unit. Crit Care Med. 2000;28:2122–2132. doi: 10.1097/00003246-200006000-00079. - DOI - PubMed
    1. Selbst SM. Adverse sedation events in pediatrics: a critical incident analysis of contributing factors. Pediatrics. 2000;105:864–865. doi: 10.1542/peds.105.4.864. - DOI - PubMed
    1. Ambuel B, Hamlett KW, Marx CM, Blumer JL. Assessing distress in pediatric intensive care environments: the COMFORT scale. J Pediatr Psychol. 1992;17:95–109. - PubMed
    1. Marx CM, Smith PG, Lowrie LH, Hamlett KW, Ambuel B, Yamashita TS, Blumer JL. Optimal sedation of mechanically ventilated pediatric critical care patients. Crit Care Med. 1994;22:163–170. - PubMed
    1. Burns AM, Shelly MP, Park GR. The use of sedative agents in critically ill patients. Drugs. 1992;43:507–515. - PubMed

Publication types