Sedation assessment in traumatic brain injury patients (V1.0)
Research type
Research Study
Full title
The use of Bispectral Index monitoring to assess depth of sedation in patients with traumatic brain injury (BIS-TBI)
IRAS ID
247784
Contact name
Callum Kaye
Contact email
Sponsor organisation
NHS Grampian
Clinicaltrials.gov Identifier
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
Research Summary
Patients with severe Traumatic Brain Injury (TBI) often require mechanical ventilation and sedation to prevent secondary brain injury. To date there remains no recommendation regarding the appropriate depth of sedation.
Current practice in Aberdeen ICU uses clinical evaluation to assess depth of sedation. Bispectral Index (BIS) is a well-established, non-invasive method of assessing depth of anaesthesia, although it is not routinely used in Aberdeen ICU.
This observational study aims to use BIS to:
• Assess the level of sedation of our TBI patients
• Describe the sedation practice of Aberdeen ICU for TBI patients
• Assess if BIS-predicted depth of anaesthesia is associated with other factors such as:
o Vasoactive medication use
o Osmotherapy useSummary of Results
We found that the level of sedation, as assessed by a bedside nurse using the usually recognised scales, was a poor reflection of the underlying brain activity. Additionally, we found that the level of brain activity was a poor indicator of the need for further treatments to manage brain swelling.
These findings suggest that if sedation is beneficial to prevent worsening brain injury by reducing brain activity, then a strategy using brain monitoring may be more effective than nurse assessments. Additionally, it suggests that sedation is not as beneficial as many people believe it is for preventing brain swelling after a severe injury.
REC name
Scotland A: Adults with Incapacity only
REC reference
18/SS/0100
Date of REC Opinion
8 Aug 2018
REC opinion
Favourable Opinion