PURPOSE: The Bispectral index monitor (BIS) is an objective method of assessing sedation and analgesia in operating rooms and has demonstrated effectiveness in the adult ICU, but has not been embraced in the pediatric intensive care units (PICU). A survey was undertaken to determine the utility of the BIS monitor in the PICU.
METHODS: A survey questionnaire on the BIS monitor was sent to physicians and nurses from PICUs all over the country identified through the ACGME and virtual PICU websites.
RESULTS: 105 of the 173 PICUs (60.7%) surveyed responded. Of these 98 were from physicians and 46 were from nurses. Majority are aware of the BIS and its use in the ICUs and have had experience in using the monitor in the past. However, only 32 of the 98 physicians (32.7%) and 22 of the 46 nurses ( 47.8%) had formal orientation or in service training on the monitor. Only 30.2% have BIS monitors in their intensive care units at this time. Only 43.9% of the physicians surveyed think the monitor is useful, in contrast to 52.2% of nurses who had favorable opinion. Of the responding institutions with PICU fellowship programs (49/60 or 81.7%), only 18.4% utilize the BIS monitor for assessment of sedation.
CONCLUSION: Adequate assessment of sedation in the pediatric population remains elusive. Several scoring systems are available but all depend on subjective evaluation. The BIS monitor has been well validated in the pediatric anesthesiology literature and shows potential for use in the PICU. However, based on this survey majority of PICUs do not use the BIS monitor. Physicians do not think highly of the monitor in contrast to nurses who had more in service training on the equipment and consider it as a useful tool.
CLINICAL IMPLICATIONS: This survey gave us insights from physicians and nurses regarding BIS utility and current practice as a sedation tool in the PICU. More prospective studies are needed to validate the use of an objective method to assess sedation and analgesia.
DISCLOSURE: Shonola Dasilva, None.