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Updated: Aug 10, 2026
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
[Use of the Bispectral Index in monitoring critically-ill children]
S Mencía Bartolomé1, J López-Herce Cid, A Lamas Ferreiro
1Sección de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, Spain. santiagomencia@yahoo.es
Insights
Bispectral Index (BIS) monitoring, a brainwave analysis tool, shows promise for assessing hypnosis depth in critically ill children. This noninvasive method aids in managing sedation and detecting neurological changes in the pediatric intensive care unit (PICU).
Area of Science:
- Neuroscience
- Critical Care Medicine
- Anesthesiology
Background:
- The Bispectral Index (BIS) quantifies brain electrical activity to measure hypnosis depth.
- While established for surgical monitoring, its use in critically ill children is less explored.
- This study investigates BIS utility in the Pediatric Intensive Care Unit (PICU).
Observation:
- BIS monitoring was evaluated in six critically ill children.
- Assessed sedation and analgesia during mechanical ventilation, with and without neuromuscular blockade.
- Monitored anesthetic effects during PICU surgery and consciousness in encephalitis.
- Observed BIS utility in early brain death detection and noted pacer-induced artifacts.
Findings:
- BIS monitoring demonstrated utility in assessing sedation and hypnosis in critically ill children.
- The method proved valuable for continuous consciousness monitoring and early brain death detection.
- Identified pacer-induced artifacts affecting BIS readings.
Implications:
- BIS monitoring offers a potentially useful, noninvasive tool for managing critically ill pediatric patients.
- May enhance the assessment of neurological status and depth of hypnosis in the PICU.
- Further research is warranted to establish standardized protocols for BIS use in pediatric critical care.
Abstract:
The Bispectral Index (BIS) is a single numeric value that indicates the depth of hypnosis by estimating the level of electrical activity in the brain through analysis of the frequency bands in the electroencephalogram. The BIS was primarily developed to monitor the level of hypnosis during surgery and has recently begun to be used in critically-ill patients. Currently, there is little experience of the BIS in critically-ill children. We present 6 cases that illustrate the utility of BIS monitoring in the PICU. We assessed sedation and analgesia during mechanical ventilation with and without neuromuscular block in two patients, and the effect of anesthetic agents during a surgical procedure in the PICU. The BIS was also useful in the continuous monitoring of the level of consciousness in a patient with encephalitis and in the early detection of brain death. Pacer-induced artefacts in the BIS value are also described. We conclude that BIS monitoring may be a useful, noninvasive method for assessing the level of hypnosis in critically-ill children.
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