{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T10:35:58Z","timestamp":1760524558455,"version":"3.40.5"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Deep sedation may be indicated in the intensive care unit (ICU) for the management of acute organ failure, but leads to sedative\u2010induced delirium. Whether processed electroencephalography (p\u2010EEG) is useful in this setting is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To describe the PSI index in deeply sedated critically ill patients with acute organ failure, and to examine a potential association between low PSI values and ICU delirium. [Correction added on 16 October 2024, after first online publication: Aim subsection in Abstract has been added on this version.]<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a single\u2010centre observational study of non\u2010neurological ICU patients sedated according to a standardized guideline of deep sedation (Richmond Agitation Sedation Scale [RASS] between \u22125 and \u22124) during the acute phase of respiratory and\/or cardio\u2010circulatory failure. The SedLine (Masimo Incorporated, Irvine, California) was used to monitor the Patient State Index (PSI) (ranging from 0 to 100, &lt;25\u2009=\u2009very deep sedation and &gt;50\u2009=\u2009light sedation to full awareness) during the first 72\u2009h of care. Delirium was assessed with the Confusion Assessment Method for the Intensive Care Unit (CAM\u2010ICU).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median duration of PSI monitoring was 43\u2009h. Patients spent 49% in median of the total PSI monitoring duration with a PSI &lt;25. Patients with delirium (<jats:italic>n<\/jats:italic>\u2009=\u200941\/97, 42%) spent a higher percentage of total monitored time with PSI &lt;25 (median 67% [19\u201391] vs. 47% [12.2\u201378.9]) in non\u2010delirious patients (<jats:italic>p<\/jats:italic> .047). After adjusting for the cumulative dose of analgesia and sedation, increased time spent with PSI &lt;25 was associated with higher delirium (odds ratio 1.014; 95% CI 1.001\u20131.027, <jats:italic>p<\/jats:italic>\u2009=\u2009.036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A clinical protocol of deep sedation targeted to RASS at the acute ICU phase may be associated with prolonged EEG suppression and increased delirium. Whether PSI\u2010targeted sedation may help reducing sedative dose and delirium deserves further clinical investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to Clinical Practice<\/jats:title><jats:p>Patients requiring deep sedation are at high risk of being over\u2010sedated and developing delirium despite the application of an evidence\u2010based sedation guideline. Development of early objective measures are essential to improve sedation management in these critically ill patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nicc.13009","type":"journal-article","created":{"date-parts":[[2023,11,25]],"date-time":"2023-11-25T01:45:14Z","timestamp":1700876714000},"page":"1781-1787","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Early processed electroencephalography for the monitoring of deeply sedated mechanically ventilated critically ill patients"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6355-3719","authenticated-orcid":false,"given":"Eva","family":"Favre","sequence":"first","affiliation":[{"name":"Department of Intensive Care Centre Hospitalier Universitaire Vaudois (CHUV)\u2010Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"},{"name":"Institute of Higher Education and Research in Healthcare 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Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8809-2920","authenticated-orcid":false,"given":"Anne\u2010Sylvie","family":"Ramelet","sequence":"additional","affiliation":[{"name":"Institute of Higher Education and Research in Healthcare CHUV\u2010Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Oddo","sequence":"additional","affiliation":[{"name":"Medical Directorate for Research, Education and Innovation CHUV\u2010Lausanne University Hospital and University of Lausanne  Lausanne 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