The Use of Bispectral Index (BIS) to Guide Sedation
Practice In the ICU
Some clinicians in the ICU use Bispectral Index (BIS) to titrate the depth of sedation, although its use has only been validated in neurologically healthy patients over one year of age  and seems to correlate poorly to the Sedation-Agitation Scale . BIS monitoring may however be usefully employed as an adjunct to reduce the incidence of awareness in critically unwell patients in certain situations (e.g. patients requiring neuromuscular blockade and during invasive procedures such as tracheostomy insertion), or to minimize over-sedation, which is associated with poorer clinical outcomes .
The aim of the survey is to inform a non-commercial study.
The results have been analysed and submitted as a poster to the Wessex Intensive Care Society Meeting in June 2015. (Click to view)
Below is a table detailing response rates from the various trainee collaboratives.
Group Number of ICUs Response
STAR 8 8
SHARC 7 7
ARNni 5 4
SEARCH KSS 11 6
SWARM 6 6
SPARC-ICM 12 12
OXICM 10 6
Total 59 52
Response Rate 88.1%
1. Sadhasivam S, Ganesh A, Robison A, Kaye R, Watcha MF. Validation of the Bispectral Index Monitor for Measuring the Depth of Sedation in Children. Anesthesia & Analgesia. 2006;102(2):383–388. doi:10.1213/01.ANE.0000184115.57837.30.
2. Nasraway SA SA, Wu EC, Kelleher RM, Yasuda CM, Donnelly AM. How reliable is the Bispectral Index in critically ill patients? A prospective, comparative, single-blinded observer study. Critical Care Medicine. 2002;30(7):1483–1487.
3. Bigham C, Bigham S, Jones C. Does the bispectral index monitor have a role in intensive care? 1A03 2C04 3A13. Journal of Intensive Care Society. 2012;13(4):314–319.
Regional Project Lead
Local Trust Project Lead
Derriford Hospital, Plymouth
Royal Cornwall Hospital, Truro
Royal Devon & Exeter Hospital, Exeter
Musgrove Park Hospital, Taunton
Torbay Hospital, Torquay
North Devon District Hospital, Barnstaple