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Caveats of Bispectral Index Monitoring in the Pediatric Population

Aryeh Shander, MD, FCCP; Gregg Lobel, MD, FAAP
Author and Funding Information

Affiliations: Englewood, NJ
 ,  Dr. Shander is Chief, Department of Anesthesiology, Critical Care Medicine, Pain Management and Hyperbaric Medicine, and Dr. Lobel is a Pediatric Anesthesiologist, Department of Anesthesiology and Critical Care Medicine, at Englewood Hospital and Medical Center.

Correspondence to: Aryeh Shander, MD, FCCP, Chief, Department of Anesthesiology, Critical Care Medicine, Pain Management and Hyperbaric Medicine, Englewood Hospital and Medical Center, 350 Engle St, Englewood, NJ 07631; e-mail: aryeh.shander@ehmc.com



Chest. 2005;128(1):14-16. doi:10.1378/chest.128.1.14
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Whether a “lumper” or a “splitter,” physicians have always battled with a way to measure organ function. Besides the difficulty in obtaining accuracy of function, outcome predictions have been and continue to be a significant challenge. Determination of global as well as local measure of organ function is a large part of daily patient care. Does monitoring of bodily and organ function help in improving the care and outcome of our patients? On examination of this question, it becomes apparent that a culture has developed that has harnessed us to monitors despite their inherent lack of accuracy and, at times, little impact on positive outcomes. For example, the measurement of oxygen saturation in the critically ill and anesthetized patient would be considered heresy if not employed in every occasion when supplemental oxygen is needed or ordered. To date, uncertainty remains if this monitor improves survival or improves quality of life in those patients who are intermittently or continuously monitored.1

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