Bispectral Monitoring on Mechanically Ventilated Patients

Bispectral Monitoring on Mechanically Ventilated Patients, a Randomized Clinical Trial. (BIMV Trial)

The purpose of this study is to determine the difference in the duration of mechanical ventilation, to evaluate the difference in ICU length of stay and to determine the difference in the overall dose of sedation medications between the between participants who were monitored using Bispectral index monitoring (BIS) monitors and those who were not.

Inclusion Criteria:

• Admission to the medical ICU
• Intubated on mechanical ventilation
• On sedation medication infusion

Exclusion Criteria:

• Patients with a history of chronic opioid use
• Patients with end-stage liver disease at ICU admission (i.e., International normalized ratio >1.5 and not taking warfarin and/or a total serum bilirubin 1.5 times above normal limits)
• Pregnant patients
• Current prisoner
• Refractory shock: Mean arterial blood pressure below 65 millimeters of mercury(65mmHg) despite maximum doses of 3 pressors. Norepinephrine 70mcg/min; vasopressin 0.03 units/min; epinephrine 35mcg/min; dopamine 20mcg/kg/min and phenylephrine 350mcg/min
• Inability to complete the required time for follow-up
• Surgical admission diagnosis
• Patients with skin conditions precluding BIS monitor sensor adherence
• Patients on neuromuscular blockade infusion or benzodiazepine infusion