A randomized controlled proof-of-concept trial of early sedation management using Responsiveness Index monitoring in mechanically ventilated critically ill patients

Deep sedation is associated with adverse patient outcomes. We recently described a novel sedation-monitoring technology, the Responsiveness Index (RI), which quantifies patient arousal using processed frontal facial EMG data. We explored the potential effectiveness and safety of continuous RI monito...

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Bibliographic Details
Published in:Critical care (London, England) England), 2015-09, Vol.19 (1), p.333-333, Article 333
Main Authors: Kaila, Markus, Everingham, Kirsty, Lapinlampi, Petteri, Peltola, Petra, Särkelä, Mika O K, Uutela, Kimmo, Walsh, Timothy S
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Analysis
Anesthesia
Care and treatment
Clinical decision making
Collaboration
Conscious Sedation - methods
Consciousness Monitors
Critical care
Decision making
Delirium
Electroencephalography
Employees
Evidence-based medicine
Female
Grants
Hospital patients
Humans
Intensive care
Male
Middle Aged
Monitoring, Physiologic - methods
Mortality
Nurses
Nursing
Pain
Respiration, Artificial - methods
Validity
Ventilators
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Summary:Deep sedation is associated with adverse patient outcomes. We recently described a novel sedation-monitoring technology, the Responsiveness Index (RI), which quantifies patient arousal using processed frontal facial EMG data. We explored the potential effectiveness and safety of continuous RI monitoring during early intensive care unit (ICU) care as a nurse decision-support tool. In a parallel-group controlled single centre proof of concept trial, patients requiring mechanical ventilation and sedation were randomized via sequential sealed envelopes following ICU admission. Control group patients received hourly clinical sedation assessment and daily sedation holds; the RI monitor was connected but data were concealed from clinical staff. The intervention group received control group care, but RI monitoring was visible and nurses were asked to adjust sedation to maintain patients with an RI>20 whenever possible. Traffic-light colour coding (RI40, Green) simplified decision-making. The intervention lasted up to 48 hours. Sixteen nurses were interviewed to explore their views of the novel technology. We analysed 74 patients treated per protocol (36 intervention; 38 control). The proportion of patients with RI
ISSN:1364-8535
1466-609X
1364-8535
1366-609X
DOI:10.1186/s13054-015-1043-1