Sirilaksanamanon Pongpol, Thawitsri Thammasak, Charuluxananan Somrat, Chirakalwasan Naricha
Department of Anesthesiology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Indian J Crit Care Med. 2023 Nov;27(11):795-800. doi: 10.5005/jp-journals-10071-24555.
Monitoring and improving sleep quality may help recovery from major illness. Polysomnography is a gold standard for measuring sleep quality, but routine use is not practical. The goal of this study is to investigate the diagnostic accuracy of an alternative monitor, the Bispectral Index (BIS), for evaluating the quality of sleep-in postoperative patients in the intensive care unit (ICU).
An observational study.
Patients admitted to postoperative ICU after elective major noncardiac surgery were monitored with both BIS and PSG during the first night. The temporally synchronized data from both monitors were obtained for measurement of the association. Clinical outcomes were compared between patients with different postoperative sleep quality.
Thirty-three patients were enrolled in this study. For determining the average BIS index associated with good postoperative sleep quality, receiver operating characteristics (ROC) curve was generated. Area under the ROC curve (AUC) was 0.65. The cutoff with best discriminability was 75 with a sensitivity of 68% and a specificity of 56%. Compared with those with good and poor postoperative sleep quality, there were no differences in main postoperative outcomes including duration of mechanical ventilation and ICU stay. Although the quality of sleep after surgery of all subjects with postoperative delirium was poor, the incidence of delirium between the groups did not significantly differ (0% vs 10.3%; = 0.184).
The monitoring of BIS is a viable tool for evaluating sleep quality in mechanically ventilated patients in the postoperative ICU with acceptable precision.
www.clinicaltrials.in.th, TCTR20200310005.
Sirilaksanamanon P, Thawitsri T, Charuluxananan S, Chirakalwasan N. Diagnostic Value of the Bispectral Index to Assess Sleep Quality after Elective Surgery in Intensive Care Unit. Indian J Crit Care Med 2023;27(11):795-800.
监测并改善睡眠质量可能有助于重大疾病的康复。多导睡眠图是测量睡眠质量的金标准，但常规使用并不实际。本研究的目的是调查一种替代监测仪——脑电双频指数（BIS）评估重症监护病房（ICU）术后患者睡眠质量的诊断准确性。
一项观察性研究。
择期进行非心脏大手术术后入住ICU的患者在术后第一晚同时接受BIS和多导睡眠图（PSG）监测。获取两台监测仪在时间上同步的数据以测量两者之间的关联。比较不同术后睡眠质量患者的临床结局。
本研究纳入了33例患者。为确定与良好术后睡眠质量相关的平均BIS指数，绘制了受试者工作特征（ROC）曲线。ROC曲线下面积（AUC）为0.65。具有最佳辨别力的临界值为75，灵敏度为68%，特异度为56%。与术后睡眠质量良好和较差的患者相比，包括机械通气时间和ICU住院时间在内的主要术后结局并无差异。尽管所有术后谵妄患者术后的睡眠质量均较差，但两组之间谵妄的发生率并无显著差异（0%对10.3%；P = 0.184）。
在术后ICU中，BIS监测是评估机械通气患者睡眠质量的一种可行工具，其精确度可接受。
www.clinicaltrials.in.th，TCTR20200310005。
西里拉卡沙纳农P，塔维斯里T，查鲁鲁克沙纳南S，奇拉卡尔瓦桑N。脑电双频指数评估重症监护病房择期手术后睡眠质量的诊断价值。《印度重症监护医学杂志》2023；27(11):795 - 800。
