Comparison of bispectral index and rass scores in sedation management of patients with severe ards: effects on mortality

Öz

Aim: Sedation management plays a critical role in the outcomes of patients with severe acute respiratory distress syndrome (ARDS). Bispectral index (BIS) and the Richmond Agitation-Sedation Scale (RASS) are two commonly used methods to assess sedation levels. This study aimed to compare BIS and RASS scores and evaluate the impact of these scores on mortality. Materials and Methods: In this retrospective study, 98 patients diagnosed with severe ARDS and under mechanical ventilation were evaluated. BIS and RASS scores were measured in both prone and supine positions, and the correlation between these scores and clinical parameters was analyzed. Patients were divided into two groups: BIS ≤40 and BIS >40, and their mortality rates were assessed. Results: A significant moderate correlation was found between BIS and RASS scores in both supine (r=0.53, p<0.001) and prone (r=0.46, p<0.001) positions. Mortality rates were 88% in the BIS ≤40 group and 81.3% in the BIS >40 group, but this difference was not statistically significant (p=0.35). Conclusion: While BIS monitoring is a valuable tool in sedation management for ARDS patients, the combined use of BIS and RASS scores may contribute to more accurate clinical outcomes in sedation management. Although BIS monitoring is useful, its effect on mortality has not been demonstrated.

Anahtar Kelimeler

• Acute Respiratory Distress Syndrome
• Bispectral Index
• Sedation Scale

Ağır ARDS hastalarında sedasyon yönetiminde bispektral indeks ve rass skorlarının karşılaştırılması: mortalite üzerine etkileri

Öz

Amaç: Ağır akut respiratuvar distres sendromu (ARDS) hastalarında sedasyon yönetimi, yoğun bakım sonuçları üzerinde kritik bir rol oynamaktadır. Bispektral indeks (BİS) ve Richmond Ajitasyon ve Sedasyon Skalası (RASS), sedasyon düzeylerini belirlemede yaygın olarak kullanılan iki yöntemdir. Bu çalışmada, BİS ve RASS skorlarının karşılaştırılması ve bu skorların mortalite üzerindeki etkilerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu retrospektif çalışmada, mekanik ventilasyon altındaki ağır ARDS tanısı almış 98 hasta değerlendirildi. BİS ve RASS skorları pron ve supin pozisyonlarında ölçüldü ve bu skorlar arasındaki korelasyon ile klinik parametreler analiz edildi. BİS ≤40 ve BİS >40 olmak üzere iki gruba ayrıldı ve mortalite açısından değerlendirildi. Bulgular: BİS ve RASS skorları arasında hem supin (r=0.53, p<0.001) hem de pron (r=0.46, p<0.001) pozisyonlarında anlamlı ve orta dereceli bir korelasyon tespit edildi. BİS ≤40 ve BİS >40 grupları arasında mortalite oranları BİS ≤40 grubunda %88, BİS >40 grubunda %81.3 olarak belirlendi, ancak bu fark istatistiksel olarak anlamlı değildi (p=0.35). Sonuç: BİS monitorizasyonu, ARDS hastalarında sedasyon yönetiminde değerli bir araç olmasına rağmen, sedasyon yönetiminde hem BİS hem de RASS skorlarının birlikte kullanılması daha doğru klinik sonuçlar elde edilmesine katkı sağlayabilir. BİS monitorizasyonu faydalı olmakla birlikte mortaliteye etkisi gösterilememiştir.

Anahtar Kelimeler

• Akut Respiratuvar Distres Sendromu
• Bispektral İndeks
• Sedasyon Skalası

Kaynakça

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