Crain et al compared the bispectral index (BIS) and the COMFORT scale for monitoring sedation in a pediatric patient in the intensive care unit (ICU). The authors are from the University of Virginia, the Children's National Medical Center and George Washington University.


The bispectral index uses EEG patterns to distinguish wakefulness vs sedation. The BIS may not correlate with the patient's level of comfort.


Bispectral Index

Level of Sedation

> 80


61 - 80


41 - 60


<= 40

very deep


Indications for monitoring the bispectral index:

(1) The patient is paralyzed (for long-term mechanical ventilation or other reason).

(2) The patient's level of sedation is difficult to assess clinically for other reasons.

(3) The patient is in deep or very deep sedation and is at risk for becoming oversedated.


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