Bundled Bispectral Index Monitoring and Sedation During Paralysis in Acute Respiratory Distress Syndrome.
AACN Adv Crit Care
; 33(3): 253-261, 2022 Sep 15.
Article
in English
| MEDLINE | ID: covidwho-2024642
ABSTRACT
BACKGROUND:
Clinical assessments of depth of sedation are insufficient for patients undergoing neuromuscular blockade during treatment of acute respiratory distress syndrome (ARDS). This quality initiative was aimed to augment objective assessment and improve sedation during therapeutic paralysis using the bispectral index (BIS).METHODS:
This quality improvement intervention provided education and subsequent implementation of a BIS monitoring and sedation/analgesia bundle in a large, urban, safety-net intensive care unit. After the intervention, a retrospective review of the first 70 admissions with ARDS assessed use and documented sedation changes in response to BIS.RESULTS:
Therapeutic neuromuscular blockade was initiated for 58 of 70 patients (82.8%) with ARDS, of whom 43 (74%) had BIS monitoring and 29.3% had bundled BIS sedation-titration orders. Explicit documentation of sedation titration in response to BIS values occurred in 27 (62.8%) of those with BIS recordings.CONCLUSIONS:
BIS sedation/analgesia bundled order sets are underused, but education and access to BIS monitoring led to high use of monitoring alone and subsequent sedation changes.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Respiratory Distress Syndrome
/
Neuromuscular Blockade
/
Anesthesia
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
AACN Adv Crit Care
Journal subject:
Nursing
/
Critical Care
Year:
2022
Document Type:
Article
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