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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2002 January-February;68(1-2):37-43

language: English

BIS and Ramsay score in critically ill patient: what future?

Mondello E., Panasiti R., Siliotti R., Floridia D., David A., Trimarchi G. *

From the Department of Neurological, Anaesthesiological and Psychiatric Sciences
*Statistical Department University of Messina, Messina


Background. The ­recent intro­duc­tion of BIS has ­improved the con­cept of uti­liz­ing it as a meth­od for the assess­ment of the seda­tion lev­el, ­thus open­ing new fron­tiers in crit­i­cal­ly ill ­patients ­care. Its valid­ity in meas­ur­ing the hyp­not­ic ­drug ­effects has ­been repeat­ed­ly ­proved, but it has rare­ly ­been ­used in ICU. The aim of ­this ­paper is to eval­u­ate the cor­re­la­tion ­between BIS and Ramsay ­score and its fluc­tu­a­tions ­with the sed­a­tive dos­age vari­a­tions, as a pos­sible util­iza­tion in ICU.
Methods. In ­this ­study, 20 ­patients ­with ­severe ­lung dis­ease requir­ing ven­ti­la­tor sup­port, ­were recruit­ed. All ­patients ­were sedat­ed ­with pro­pof­ol and/or mid­az­o­lam to man­tain a Ramsay ­score of 4. Continuous infu­sion tech­niques ­were com­mon­ly ­used. At ­time 0 and eve­ry ­half an ­hour, the ­patients ­were eval­u­at­ed by 2 inves­ti­ga­tors, ­using the Ramsay ­score and the BIS simul­ta­ne­ous­ly. The BIS was cal­cu­lat­ed by a 1-min record­ing eve­ry ­time ­that the seda­tion ­score was record­ed, for a ­total of 960 obser­va­tions. In addi­tion BIS was con­ti­nous­ly record­ed to estab­lish a base­line val­ue, ­when the ­patient was not stim­u­lat­ed. Ventilator set­tings, med­i­ca­tions and ­vital ­signs ­were ­also record­ed.
Results. With the ­increase of the Ramsay ­score ­there was a pro­gres­sive ­decrease in the BIS ­score (Ramsay ­score=2, BIS=88±15.1; Ramsay ­score=6, BIS=52.2±10.7); ­between BIS and Propofol dos­ag­es and ­between Ramsay ­score and sys­tol­ic pres­sure.
Conclusions. The ­data ­obtained ­show a ­good cor­re­la­tion ­between Ramsay ­score and BIS.

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