{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T11:53:04Z","timestamp":1761393184980,"version":"build-2065373602"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,1,16]],"date-time":"2012-01-16T00:00:00Z","timestamp":1326672000000},"content-version":"vor","delay-in-days":3059,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:p>\n                    <jats:bold>Objective.<\/jats:bold>\n                    The bispectral index (BIS), a processed variable derived from the raw electroencephalogram (EEG) used to guide sedation in the intensive care unit (ICU), has not been tested during barbiturate therapy for elevated intracranial pressure. We determined the BIS and suppression ratio (SR) values during traditional burst monitoring of the raw EEG during pentobarbital infusions.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design.<\/jats:bold>\n                    Prospective, observational cohort study.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting. A<\/jats:bold>\n                    42\u2010bed multidisciplinary ICU in a tertiary care medical center.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Patients.<\/jats:bold>\n                    Twelve consecutive patients with elevated intracranial pressure treated with pentobarbital infusions.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Intervention.<\/jats:bold>\n                    All patients were monitored continuously with the Aspect Medical Systems A\u20101050 bedside EEG monitor using a bilateral referential montage. Pentobarbital doses were titrated based on the raw EEG to attain a burst\u2010suppression pattern with a goal of 3\u20135 bursts\/minute. Drug dosage, intracranial pressure, cerebral perfusion pressure values, EEG bursts\/minute, BIS version 3.2, and SR were recorded daily.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Measurements and Main Results.<\/jats:bold>\n                    The 12 patients were monitored for 62 patient\u2010days. Mean \u00b1 SD age was 32 \u00b1 15 years, seven (58%) patients were male, mean Acute Physiology and Chronic Heath Evaluation II score was 17.0 \u00b1 5.0, and hospital mortality was 42%. The mean pentobarbital infusion rate was 124 \u00b1 49 mg\/hour or 2.3 \u00b1 1.3 mg\/kg\/hour, and mean pentobarbital serum concentration was 29.7 \u00b1 13 \u03bcg\/ml. The mean BIS value was 18 \u00b1 14, mean SR 56% \u00b1 36%; BIS correlated well with SR (r=\u20100.99, p&lt;0.001). For patient\u2010days with a burst\u2010suppression pattern, BIS 3.2 (r=0.90, p&lt;0.001) and SR (r=\u20100.89, p&lt;0.001) strongly correlated with the number of bursts\/minute. The mean BIS value corresponding to 3\u20135 bursts\/minute was 15 (95% confidence interval [CI] 10\u201320); SR value was 71 (95% CI 61\u201380).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion.<\/jats:bold>\n                    The Aspect A\u20101050 applied to patients and monitored by nurses and physicians works well as a bedside EEG monitor, providing a raw EEG signal to titrate barbiturate therapy. The continuous data trend and realtime digital output for the BIS and SR quantify the degree of EEG suppression well and may prove helpful in facilitating titration of barbiturate infusions.\n                  <\/jats:p>","DOI":"10.1592\/phco.23.10.1087.32766","type":"journal-article","created":{"date-parts":[[2004,5,14]],"date-time":"2004-05-14T05:48:28Z","timestamp":1084513708000},"page":"1087-1093","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Comparing the Bispectral Index and Suppression Ratio with Burst Suppression of the Electroencephalogram During Pentobarbital Infusions in Adult Intensive Care Patients"],"prefix":"10.1002","volume":"23","author":[{"given":"Richard R.","family":"Riker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilles 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