Intensive Care Clinical Trial
Official title:
The Impact of Bispectral Index Monitoring on Sedation Administration in Mechanically Ventilated Patients
This prospective randomised controlled trial was designed to assess the effectiveness of the
Bispectral Index Sedation (BIS) monitor in supporting clinical, sedation management
decisions in mechanically ventilated ICU patients.
The primary hypothesis for the study is that patients with Bispectral Index Sedation (BIS)
monitoring will receive less sedation then those receiving standard sedation management.
The secondary hypotheses are:
1. Patients with BIS have fewer ventilation days than those receiving standard sedation
management.
2. Level of sedation administered will differ according to the critical care experience
and qualification of the nurse.
Patients in intensive care units (ICUs) frequently require sedatives and analgesics as part
of therapy. Assessing the appropriate dose of sedative and analgesic drugs can be difficult
due to the severity of the patient's illness, inability of the patient to communicate,
multiple procedures and transports for investigations and the subjectivity of clinical
sedation assessment tools. Poorly assessed and managed levels of sedation can result in over
sedation, extended ventilation time and a potentially extended ICU stay.
The BIS monitor is derived from the electroencephalogram and provides a numeric value that
represents a measure of cerebral activity. Such an objective measure of the patient's level
of sedation may provide a useful tool that will enable nurses to titrate sedation more
accurately in an attempt to provide the optimal level of sedation for all ICU patients.
The study will be conducted in the Intensive Care Unit at the Alfred Hospital. This study is
designed as a prospective randomised control trial with parallel design. This means that
participants' will be randomly allocated into either one of two groups - an intervention or
control group. Participant's randomised to the intervention group will receive BIS
monitoring. The control group will receive standard ICU sedation assessment and management.
To determine if BIS monitoring is useful in ICU, information will be collected by auditing
patient charts and determining the average amounts of sedation medication for each nursing
shift. In addition, the years of critical care experience and critical care qualification
will be recorded for each nurse managing patients recruited to the study.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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