Abstract：
OBJECTIVES:Processed EEG monitoring has been suggested for sedation depth evaluation in intensive care unit (ICU) patients. The present study investigated the efficacy of two processed EEG monitors using SEF90% or SEF95% and BIS to differentiate between conscious (Ramsay score 4) and unconscious sedation (Ramsay score 6). DESIGN AND SETTING:Prospective, randomized trial in a surgical ICU of a university teaching hospital. PATIENTS:Patients recovering from elective coronary bypass grafting. INTERVENTION:One of two EEG analyzers was installed (A: Aspect A-1000 measuring SEF95% and BIS; D: Drager pEEG measuring SEF90%). At ICU admission unconscious sedation (Ramsay score 6), and at three 30-min intervals conscious sedation (Ramsay score 4) were investigated. MEASUREMENTS AND RESULTS:Fourteen patients were monitored by A and 14 by D. The interindividual variability (coefficient of variation 32-69 %) was large for all three processed EEG methods. SEF90% of analyzer D and BIS of analyzer A showed a statistically significant difference between unconscious and conscious sedation (11 +/- 3 and 17 +/- 6 Hz, p = 0.005; 74 +/- 10 and 83 +/- 10, p = 0.02). Positive and negative predictive values for SEF90% of analyzer D (0.57, 95% CI 0.34-0.77; and 0.92, 95% CI 0.64-0.99) and BIS of analyzer A (0.55, 95 % CI 0.32-0.76; and 0.87, 95 % CI 0.60-0.98) were too low for discrimination between conscious and unconscious sedation. CONCLUSIONS:The use of processed EEG monitoring cannot be recommended for assessing sedation depth after cardiac surgery.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Walder B,Suter PM,Romand JAdoi
10.1007/s001340000761keywords:
subject
Has Abstractpub_date
2001-01-01 00:00:00pages
107-14issue
1eissn
0342-4642issn
1432-1238journal_volume
27pub_type
临床试验,杂志文章,随机对照试验abstract：OBJECTIVE:To describe the clinical course of quinine-induced disseminated intravascular coagulation (DIC) and review all previous cases reported in the medical literature. DESIGN:Case report/literature review. SETTING:University teaching hospital medical ICU. PATIENTS:One patient in whom thrombocytopenia, coagulopat...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-003-1732-0
更新日期：2003-06-01 00:00:00
abstract：:A prospective study of thiamine status in patients with severe injuries (injury severity scores greater than 12) showed that they all developed signs of severe thiamine deficiency on the basis of transketolase activity, the standard biochemical test for thiamine deficiency. This occurred within the first week after th...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00256767
更新日期：1988-01-01 00:00:00
abstract：OBJECTIVE:To assess the effects of the association of positive end-expiratory pressure (PEEP) with different inflation volumes (V(T)'s) on passive lung deflation and alveolar recruitment in ARDS patients. DESIGN:Clinical study using PEEP with two different V(T)'s and analyzing whether passive lung deflation and alveol...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051275
更新日期：2000-07-01 00:00:00
abstract：:A case of metabolic acidosis, acute renal failure and hepatic failure following paracetamol ingestion is presented. The diagnostic difficulty at presentation is highlighted. Continuous arteriovenous haemofiltration proved a valuable means of maintaining fluid and electrolyte balance. The patient recovered. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00262905
更新日期：1988-01-01 00:00:00
abstract：: ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-018-5063-6
更新日期：2018-12-01 00:00:00
abstract：OBJECTIVE:To assess the value of the diagnosis of overt disseminated intravascular coagulation (DIC) according to the International Society on Thrombosis and Haemostasis (ISTH) criteria and that of the parameters included in the ISTH score for overt DIC in predicting day 28 mortality in intensive care patients. Also, t...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-2685-2
更新日期：2005-09-01 00:00:00
abstract：:The reliability of cardiac output estimation by thermodilution during artificial ventilation was studied in anesthetized pigs at the right side of the heart. The estimates exhibited a cyclic modulation related to the ventilation. The amplitude of the modulation was independent of the level of positive end-expiratory p...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00254515
更新日期：1986-01-01 00:00:00
abstract：OBJECTIVE:To investigate the morphological changes in the liver in patients with organ failure and hyperbilirubinemia and to correlate them to the outcome. DESIGN:A case series prospective study. SETTING:Intensive care units of two general hospitals. PATIENTS:Twelve patients in organ failure with predominant hepatic...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01708095
更新日期：1996-06-01 00:00:00
abstract：OBJECTIVE:To examine whether an appropriately designed combination of an index of ventilatory endurance and the frequency divided by tidal volume ratio (f/VT) provides prognostic information for weaning outcome not offered by any index alone. DESIGN AND SETTING:Prospective study in a multidisciplinary intensive care u...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-006-0104-y
更新日期：2006-05-01 00:00:00
abstract：PURPOSE:Mechanical ventilation with lower tidal volumes (≤6 ml/kg of predicted body weight, PBW) could benefit patients without acute respiratory distress syndrome (ARDS). However, tidal volume reduction could be associated with increased patient discomfort and sedation needs, and consequent longer duration of ventilat...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00134-014-3318-4
更新日期：2014-07-01 00:00:00
abstract：OBJECTIVE:To determine the clinical impact of bedside colonoscopy for critically ill patients with acute lower gastrointestinal (GI) bleeding. DESIGN AND SETTING:A 3-year retrospective analysis (chart review). Medical intensive care unit (ICU) of a 1,312-bed tertiary-care center in Taiwan. PATIENTS AND PARTICIPANTS:F...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-2604-6
更新日期：2005-05-01 00:00:00
abstract：OBJECTIVE:Evaluation of the distribution and antibiotic susceptibility of the aerobic gram-negative bacilli (AGNB) isolated from patients in intensive care units (ICU study). DESIGN AND SETTING:Microbiological study carried out in 1991 in 39 teaching hospitals. A standardized method was used to determine the minimum i...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01699228
更新日期：1996-10-01 00:00:00
abstract：BACKGROUND:Posterior reversible encephalopathy syndrome (PRES) is a well-recognized clinico-neuroradiological transient condition. Early recognition is of paramount importance for prompt control of blood pressure or removal of precipitating factors and treatment of epileptic seizures or status epilepticus. Delay in the...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-006-0459-0
更新日期：2007-02-01 00:00:00
abstract：PURPOSE:This study explored differences in end-of-life (EOL) decisions and respect for patient autonomy of religious members versus those only affiliated to that particular religion (affiliated is a member without strong religious feelings). METHODS:In 2005 structured questionnaires regarding EOL decisions were distri...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2554-8
更新日期：2012-07-01 00:00:00
abstract：PURPOSE:To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on essential equipment, pharmaceuticals and supplies. METHODS:Based on a literature review and expert opinion, a Delphi process was use...
journal_title：Intensive care medicine
pub_type： 指南,杂志文章
doi：10.1007/s00134-010-1763-2
更新日期：2010-04-01 00:00:00
abstract：: ...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-018-5107-y
更新日期：2018-11-01 00:00:00
abstract：OBJECTIVE:The interchangeability of continuous measurement of cardiac output (CO) with the traditional bolus method in patients after cardiopulmonary bypass (CPB) is uncertain. DESIGN:Prospective observational clinical study. SETTING:A 20-bed surgical ICU at a university hospital. PATIENTS:Fourteen deeply sedated, v...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-006-0161-2
更新日期：2006-06-01 00:00:00
abstract：OBJECTIVE:Both serum levels of tumor necrosis factor-alpha (TNF alpha) and interleukin-6 (IL-6) and blood lactate levels in patients with septic shock have been shown to correlate with prognosis. The aim of the study was to define the relative predictive value of these measures. PATIENTS:38 hospitalized patients with ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01712155
更新日期：1996-05-01 00:00:00
abstract：INTRODUCTION:Trials of tight glucose control have compared measures of central tendency, such as average blood glucose, and yielded conflicting results. Other metrics, such as standard deviation, reflect different properties of glucose control and are also associated with changes in outcome. It is possible, therefore, ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-2103-2
更新日期：2011-03-01 00:00:00
abstract：OBJECTIVE:To explore the consequences of helium/oxygen (He/O(2)) inhalation on respiratory mechanics, gas exchange, and ventilation-perfusion (VA/Q) relationships in an animal model of severe induced bronchospasm during mechanical ventilation. DESIGN:Prospective, interventional study. SETTING:Experimental animal labo...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1779-y
更新日期：2003-09-01 00:00:00
abstract：OBJECTIVES:Controversies concerning the pivotal trial and negative results from other Drotrecogin alfa activated (DAA) trials have raised questions about its efficacy in severe sepsis patients. Based on all available evidence, our study aimed to respond to: (1) What is the current probability that DAA is not better tha...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1159-8
更新日期：2008-10-01 00:00:00
abstract：OBJECTIVE:The association of acute-phase reaction and outcome of patients with acute vascular diseases is controversial. The prognostic value of admission C-reactive protein (CRP) in patients with acute aortic aneurysm or dissection has not yet been investigated. DESIGN AND SETTING:Cohort study including 255 consecuti...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1299-1
更新日期：2002-06-01 00:00:00
abstract：OBJECTIVE:To describe hyperglycaemia as a possible marker of morbidity and mortality in critically ill medical and surgical patients admitted to a multidisciplinary ICU. DESIGN:Prospective cohort study. SETTING:A 13-bed non-cardiac multidisciplinary ICU in a university hospital. PATIENTS AND PARTICIPANTS:Adult patie...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2325-2
更新日期：2004-08-01 00:00:00
abstract：OBJECTIVE:To measure the effect of intense neuromuscular blockade (NMB) on oxygen consumption (VO(2)) in deeply sedated and mechanically ventilated children on the first day after complex congenital cardiac surgery. DESIGN:Prospective clinical interventional study. SETTING:Pediatric intensive care unit of an universi...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1252-z
更新日期：2008-12-01 00:00:00
abstract：OBJECTIVE:To determine the incidence rates of hospital acquired infections (HAI) during the first 14 days after ICU discharge after treatment during ICU-stay with Selective Decontamination of the Digestive tract (SDD), Selective Oropharyngeal Decontamination (SOD) or Standard Care (SC). DESIGN:Prospective observationa...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1554-9
更新日期：2009-09-01 00:00:00
abstract：OBJECTIVE:To examine the relationship of fluid balance and weaning outcomes. METHODS:We prospectively collected demographic, physiological, daily fluid balance (measured inputs minus outputs), and weaning data from 87 mechanically ventilated patients. PATIENTS:We examined 87 patients, a median age of 66 years, APACHE...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-2801-3
更新日期：2005-12-01 00:00:00
abstract：:A case of bilateral pseudoaneurysms of the pulmonary arteries caused by blunt chest injury is presented. Although this is a very rare complication, this entity should always be suspected in a patient with hemoptysis and a radiodensity on chest radiograph following chest injury. Selection of operative procedures should...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF01706428
更新日期：1992-01-01 00:00:00
abstract：PURPOSE:To compare the concentration conformity of infusion solutions manually prepared on intensive care units (ICU) with solutions from pharmacy-based, automated production. METHODS:A prospective observational study conducted in a university hospital in Germany. Drug concentrations of 100 standardised infusion solut...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-011-2230-4
更新日期：2011-08-01 00:00:00
abstract：:Values obtained for cardiac output (CO) were compared using thermodilution (TD) with those obtained using bioimpedance (Bi) as measured using the Bomed NCCOM3 (Revision 6) in 28 consecutive patients in the first 24 h after coronary artery bypass surgery (CABS). In 46 paired measurements made in the first 12 h after CA...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01720674
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVE:To quantify the variability in the concentration of drug infusions prepared on an intensive care unit and establish whether there was a relationship between the quality of syringe labeling and drug preparation. DESIGN:Audit carried out over 3 weeks in May 2006 and completed in May 2007. SETTING:The adult ne...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1113-9
更新日期：2008-08-01 00:00:00
