Çiler ZİNCİRCİOĞLU, Aykut SARITAŞ, Meltem ÇAKMAK, Uğur UZUN, Işıl KÖSE GÜLDOĞAN, NİMET ŞENOĞLU

YOĞUN BAKIM ÜNİTESİNDE MEKANİK VENTİLASYON UYGULANAN HASTALARDA KLİNİK SEDASYON SKORLARI İLE BİSPEKTRAL İNDEKS ARASINDAKİ KORELASYONUN DEĞERLENDİRİLMESİ

Giriş: Yoğun bakım Ünitesinde (YBÜ) hasta konforunu ve güvenliğini arttırmak amacıyla sedasyon uygulaması tedavi yönteminin önemli bir parçasıdır. Sedasyon uygulamasında aşırı veya yetersiz sedasyondan kaçınılması için sübjektif veya objektif değerlendirme yöntemleri ile sedasyon monitörizasyonu gereklidir. Bu çalışmanın amacı deksmedetomidin infüzyonu uygulanan mekanik ventilatör desteğindeki hastalarda bispektral indeks (BİS) monitörizasyonu ile sübjektif skalalardan Richmond Ajitasyon- Sedasyon Skalası (RASS), Ramsey Sedasyon Skalası (RSS) ve Riker Sedasyon Ajitasyon Skalası (SAS) arasındaki korelasyonun değerlendirilmesidir. Gereç ve Yöntem: Sedasyon uygulanan mekanik ventilasyon desteğindeki 40 hasta çalışmaya dahil edildi. BIS değeri 60-80 arasında olacak şekilde 0.2-0.7μgr/kg/saat aralığında deksmedetomidin dozu titre edildi. Hastaların önce BİS değerleri daha sonra RASS, RSS ve SAS değerleri 2 saat ara ile 24 saat süresince kaydedildi. İstatiksel hesaplamalar her 2 saatte bir ölçülen değerler alınarak yapıldı. Bulgular: Çalışmamızda BIS ölçekleri ile RASS ve RSS arasında yüksek, BIS ve SAS arasında orta şiddette anlamlı korelasyon saptandı. Korelasyon katsayısı en yüksek RASS için (r= 0,744) (p < 0.001) bulundu. RSS için (r= -0,723) ) (p < 0.001) ve SAS için (r= 0.420 ) ) (p < 0.001) olacak şekilde korelasyon katsayıları saptandı. Sonuç: Çalışmamızın sonuçlarına göre BIS monitörü ve RASS, RSS ve SAS arasında istatistiksel olarak anlamlı, korelasyon bulundu. Çalışmamız, BIS monitörizasyonunun YBÜ’sindeki hastalarda sedasyonu değerlendirmede yardımcı veya alternatif bir yöntem olarak uygulanabilecek anlamlı ve objektif bir araç olduğunu göstermektedir.

ASSESSMENT OF THE CORRELATION BETWEEN THE CLINICAL SEDATION SCORES AND BISPECTRAL INDEX IN MECHANICALLY VENTILATED PATIENTS IN INTENSIVE CARE UNIT

Introduction: Sedation is an important part of the treatment method to improve patient comfort and safety in the intensive care unit (ICU). In order to avoid over or under sedation, sedation monitoring by subjective and objective evaluation methods is required. The aim of this study was to compare the correlation between bispectral index (BIS) monitor and subjective clinical scales (Ramsay Sedation Scale (RSS), Richmond Agitation Sedation Scale (RASS), Sedation Agitation Scale(SAS), in mechanically ventilated patients who received dexmedetomidin infusion, in intensive care unit (ICU). Materials and Method: Mechanically ventilated forty patients who required sedation were the subjects of the study. The dose of dexmedetomidine was titrated in the range of 0.2-0.7μgr kg/h with a BIS level of 60-80. After the BIS values of the patients were recorded, RASS, RSS and SAS values were recorded at 24 hours with 2 hour intervals. Statistical calculations were made by taking the measured values every 2 hours. Results: In our study, a high correlation was found between BIS scales and RASS and RSS, and a moderate correlation between BIS and SAS. The correlation coefficient was found (r = 0.744)(p

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