Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-26T16:09:49.920Z Has data issue: false hasContentIssue false

A rational approach to the control of sedation in intensive care unit patients based on closed-loop control

Published online by Cambridge University Press:  16 August 2006

S. Albrecht
Affiliation:
Department of Anesthesiology, University of Erlangen-Nuremberg, Erlangen, Germany
C. Frenkel
Affiliation:
Department of Anesthesiology, Rheinische Friedrich-Wilhelms Universität Bonn, Germany
H. Ihmsen
Affiliation:
Department of Anesthesiology, University of Erlangen-Nuremberg, Erlangen, Germany
J. Schüttler
Affiliation:
Department of Anesthesiology, University of Erlangen-Nuremberg, Erlangen, Germany
Get access

Abstract

Optimal control of long-term sedation during therapy in the intensive care unit is difficult to achieve in a number of patients when based on commonly used clinical sedation scores alone. We therefore used the median frequency of the EEG power spectrum as a quantitative measure for closed-loop administration of propofol in 21 artificially ventilated patients (nine trauma, 12 non-trauma). The EEG setpoint was correlated with a clinical sedation score and defined such, that mechanical ventilation was tolerated. The sedative therapy was given for 31±30 h. Non-trauma patients required sedation with an EEG median frequency between 2 and 3 Hz (propofol consumption: 1.4±0.8 mg kg−1 H−1) and sedation seemed to follow some circadian patterns, whereas trauma patients needed significantly deeper sedation (EEG median frequency: 1–2 Hz; propofol consumption: 2.6±0.8 mg kg−1 h−1). We conclude that the EEG closed-loop system could safely and reliably administer propofol to maintain a predetermined level of sedation for patients in intensive care unit over a protracted time.

Type
Original Article
Copyright
1999 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)