A Review of Bispectral Index Utility in Neurocritical Care Patients

Context: Bispectral Index (BIS) was introduced in 1960 to monitor the depth of anesthesia in the operating rooms. It has been recently used to monitor the sedation in the critically ill patients hospitalized in intensive care and neurocritical care units (NCCU). Evidence Acquisition: Patients in the NCCU, particularly those with prolonged mechanical ventilation require appropriate adjust-ments in the administration of sedative drugs. Similarly, those who require neuro protection with barbiturates need to be closely monitored in the depth of their coma. Results: BIS may be a useful tool in this situation, and it can also help shorten the duration of mechanical ventilation by determining the appropriate time to eliminate patients from mechanical ventilation. We conducted a literature search to evaluate the utility of BIS monitoring in the NCCU patients with subarachnoid hemorrhage, intracranial hemorrhage, coma, cerebral hypoxia, status epilepticus and traumatic brain injury. Conclusions: BIS monitoring may be a useful adjunct to take care of the patients. However, further studies with a larger population and better design are required to substantiate the role of BIS monitoring in the care of NCCU patients.