Automated sedation outperforms manual administration of propofol and remifentanil in critically ill patients with deep sedation: A randomized phase II trial

Intensive Care Medicine

Volumn 39, Issue 3, 2013, Pages 454-462

  Le Guen, Morgan ^a   Liu, Ngai ^a,b   Bourgeois, Eric ^a   Chazot, Thierry ^a   Sessler, Daniel I ^b   Rouby, Jean Jacques ^c   Fischler, Marc ^a  

^a LABORATOIRE DES SCIENCES DU CLIMAT ET DE L ENVIRONNEMENT   (France)

^b LERNER RESEARCH INSTITUTE   (United States)

^c PITIÉ SALPÊTRIÈRE HOSPITAL   (France)

Author keywords

Anesthesia; Bispectral index; Closed loop system; Critical care; Sedation

Indexed keywords

PROPOFOL; REMIFENTANIL;

ADULT; AGED; ARTICLE; AUTOMATED SEDATION; BISPECTRAL INDEX; CENTRAL VENOUS CATHETER; CLINICAL ARTICLE; CONTROLLED STUDY; CRITICALLY ILL PATIENT; DEEP SEDATION; FEASIBILITY STUDY; FEMALE; HUMAN; INFUSION PUMP; INFUSION RATE; INTENSIVE CARE UNIT; INTERMETHOD COMPARISON; MALE; MULTIPLE ORGAN FAILURE; OUTCOME ASSESSMENT; PHASE 2 CLINICAL TRIAL; PROSPECTIVE STUDY; RANDOMIZED CONTROLLED TRIAL; SEDATION;

ADULT; AGED; ALGORITHMS; ANESTHETICS, INTRAVENOUS; AUTOMATION; CRITICAL ILLNESS; DEEP SEDATION; FEMALE; HUMANS; HYPNOTICS AND SEDATIVES; MALE; MIDDLE AGED; PIPERIDINES; PROPOFOL; PROSPECTIVE STUDIES; SINGLE-BLIND METHOD;

EID: 84884211877     PISSN: 03424642     EISSN: 14321238     Source Type: Journal    
DOI: 10.1007/s00134-012-2762-2     Document Type: Article

References (42)

1. Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, Chalfin DB, Masica MF, Bjerke HS, Coplin WM, Crippen DW, Fuchs BD, Kelleher RM, Marik PE, Nasraway SA Jr, Murray MJ, Peruzzi WT, Lumb PD (2002) Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med 30:119-141
2. Soliman HM, Melot C, Vincent JL (2001) Sedative and analgesic practice in the intensive care unit: the results of a European survey. Br J Anaesth 87:186-192
3. Kollef MH, Levy NT, Ahrens TS, Schaiff R, Prentice D, Sherman G (1998) The use of continuous i.v. sedation is associated with prolongation of mechanical ventilation. Chest 114:541-548
4. Payen JF, Chanques G, Mantz J, Hercule C, Auriant I, Leguillou JL, Binhas M, Genty C, Rolland C, Bosson JL (2007) Current practices in sedation and analgesia for mechanically ventilated critically ill patients: a prospective multicenter patient-based study. Anesthesiology 106:687-695 (quiz 891-682)
5. Society of Critical Care Medicine and American Society of Health-System Pharmacists (2002) Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Am J Health Syst Pharm 59:150-178
6. Kress JP, Pohlman AS, O'Connor MF, Hall JB (2000) Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 342:1471-1477
7. Strom T, Martinussen T, Toft P (2010) A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet 375:475-480
8. Rinehart J, Liu N, Alexander B, Cannesson M (2012) Review article: closed-loop systems in anesthesia: is there a potential for closed-loop fluid management and hemodynamic optimization? Anesth Analg 114:130-143
9. Agarwal J, Puri GD, Mathew PJ (2009) Comparison of closed loop vs. manual administration of propofol using the Bispectral index in cardiac surgery. Acta Anaesthesiol Scand 53:390-397
10. Liu N, Chazot T, Trillat B, Michel-Cherqui M, Marandon JY, Law-Koune JD, Rives B, Fischler M (2008) Closed-loop control of consciousness during lung transplantation: an observational study. J Cardiothorac Vasc Anesth 22:611-615
11. Liu N, Chazot T, Hamada S, Landais A, Boichut N, Dussaussoy C, Trillat B, Beydon L, Samain E, Sessler DI, Fischler M (2011) Closed-loop coadministration of propofol and remifentanil guided by bispectral index: a randomized multicenter study. Anesth Analg 112:546-557
12. Kam PC, Cardone D (2007) Propofol infusion syndrome. Anaesthesia 62:690-701
13. Cantraine FR, Coussaert EJ (2000) The first object oriented monitor for intravenous anesthesia. J Clin Monit Comput 16:3-10
14. Schnider TW, Minto CF, Gambus PL, Andresen C, Goodale DB, Shafer SL, Youngs EJ (1998) The influence of method of administration and covariates on the pharmacokinetics of propofol in adult volunteers. Anesthesiology 88:1170-1182
15. Minto CF, Schnider TW, Egan TD, Youngs E, Lemmens HJ, Gambus PL, Billard V, Hoke JF, Moore KH, Hermann DJ, Muir KT, Mandema JW, Shafer SL (1997) Influence of age and gender on the pharmacokinetics and pharmacodynamics of remifentanil. I. Model development. Anesthesiology 86:10-23
16. Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, Lavagne P, Jacquot C (2001) Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med 29:2258-2263
17. Le Gall JR, Lemeshow S, Saulnier F (1993) A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 270:2957-2963
18. Le Gall JR, Neumann A, Hemery F, Bleriot JP, Fulgencio JP, Garrigues B, Gouzes C, Lepage E, Moine P, Villers D (2005) Mortality prediction using SAPS II: an update for French intensive care units. Crit Care 9:R645-R652
19. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 22:707-710
20. Ramsay MA (2000) Measuring level of sedation in the intensive care unit. JAMA 284:441-442
21. Besch G, Liu N, Samain E, Pericard C, Boichut N, Mercier M, Chazot T, Pili-Floury S (2011) Occurrence of and risk factors for electroencephalogram burst suppression during propofol-remifentanil anaesthesia. Br J Anaesth 107:749-756
22. Liu N, Chazot T, Trillat B, Pirracchio R, Law-Koune JD, Barvais L, Fischler M (2006) Feasibility of closed-loop titration of propofol guided by the Bispectral Index for general anaesthesia induction: a prospective randomized study. Eur J Anaesthesiol 23:465-469
23. Ramsay MA, Savege TM, Simpson BR, Goodwin R (1974) Controlled sedation with alphaxalone-alphadolone. Br Med J 2:656-659
24. Rampil IJ (1998) A primer for EEG signal processing in anesthesia. Anesthesiology 89:980-1002
25. Johansen JW (2006) Update on bispectral index monitoring. Best Pract Res Clin Anaesthesiol 20:81-99
26. Karamchandani K, Rewari V, Trikha A, Batra RK (2010) Bispectral index correlates well with Richmond agitation sedation scale in mechanically ventilated critically ill patients. J Anesth 24:394-398
27. Trouiller P, Fangio P, Paugam-Burtz C, Appere-de-Vecchi C, Merckx P, Louvet N, Pease S, Outin H, Mantz J, De Jonghe B (2009) Frequency and clinical impact of preserved bispectral index activity during deep sedation in mechanically ventilated ICU patients. Intensive Care Med 35:2096-2104
28. Olson DM, Thoyre SM, Peterson ED, Graffagnino C (2009) A randomized evaluation of bispectral index-augmented sedation assessment in neurological patients. Neurocrit Care 11:20-27
29. Frenzel D, Greim CA, Sommer C, Bauerle K, Roewer N (2002) Is the bispectral index appropriate for monitoring the sedation level of mechanically ventilated surgical ICU patients? Intensive Care Med 28:178-183
30. Tonner PH, Weiler N, Paris A, Scholz J (2003) Sedation and analgesia in the intensive care unit. Curr Opin Anaesthesiol 16:113-121
31. Consales G, Chelazzi C, Rinaldi S, De Gaudio AR (2006) Bispectral Index compared to Ramsay score for sedation monitoring in intensive care units. Minerva Anestesiol 72:329-336
32. Guignard B, Menigaux C, Dupont X, Fletcher D, Chauvin M (2000) The effect of remifentanil on the bispectral index change and hemodynamic responses after orotracheal intubation. Anesth Analg 90:161-167
33. Liu N, Chazot T, Huybrechts I, Law-Koune JD, Barvais L, Fischler M (2005) The influence of a muscle relaxant bolus on bispectral and datex-ohmeda entropy values during propofol-remifentanil induced loss of consciousness. Anesth Analg 101:1713-1718
34. Sackey PV (2008) Frontal EEG for intensive care unit sedation: treating numbers or patients? Crit Care 12:186
35. Nasraway SS Jr, Wu EC, Kelleher RM, Yasuda CM, Donnelly AM (2002) How reliable is the Bispectral Index in critically ill patients? A prospective, comparative, single-blinded observer study. Crit Care Med 30:1483-1487
36. Solanki A, Puri GD, Mathew PJ (2010) Bispectral index-controlled postoperative sedation in cardiac surgery patients: a comparative trial between closed loop and manual administration of propofol. Eur J Anaesthesiol 27:708-713
37. Strom T, Toft P (2011) Time to wake up the patients in the ICU: a crazy idea or common sense? Minerva Anestesiol 77:59-63
38. Vasile B, Rasulo F, Candiani A, Latronico N (2003) The pathophysiology of propofol infusion syndrome: a simple name for a complex syndrome. Intensive Care Med 29:1417-1425
39. Seder DB, Fraser GL, Robbins T, Libby L, Riker RR (2010) The bispectral index and suppression ratio are very early predictors of neurological outcome during therapeutic hypothermia after cardiac arrest. Intensive Care Med 36:281-288
40. Menache CC, Bourgeois BF, Volpe JJ (2002) Prognostic value of neonatal discontinuous EEG. Pediatr Neurol 27:93-101
41. Watson PL, Shintani AK, Tyson R, Pandharipande PP, Pun BT, Ely EW (2008) Presence of electroencephalogram burst suppression in sedated, critically ill patients is associated with increased mortality. Crit Care Med 36:3171-3177
42. Monk TG, Weldon BC (2010) Anesthetic depth is a predictor of mortality: it's time to take the next step. Anesthesiology 112:1070-1072