Bispectral index in hypercapnic encephalopathy associated with COPD exacerbation: a pilot study
Roberto Chalela,1–3 Lluis Gallart,4,5 Sergi Pascual-Guardia,1–3 Antonio Sancho-Muñoz,1,2 Joaquim Gea,1–3 Mauricio Orozco-Levi1–3 1Respiratory Medicine Department, Hospital del Mar-IMIM, Barcelona, Spain; 2Department CEXS, Universitat Pompeu Fabra,...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-09-01
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| Series: | International Journal of COPD |
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| Online Access: | https://www.dovepress.com/bispectral-index-in-hypercapnic-encephalopathy-associated-with-copd-ex-peer-reviewed-article-COPD |
| _version_ | 1818299168242794496 |
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| author | Chalela R Gallart L Pascual-Guardia S Sancho-Muñoz A Gea J Orozco-Levi M |
| author_facet | Chalela R Gallart L Pascual-Guardia S Sancho-Muñoz A Gea J Orozco-Levi M |
| author_sort | Chalela R |
| collection | DOAJ |
| description | Roberto Chalela,1–3 Lluis Gallart,4,5 Sergi Pascual-Guardia,1–3 Antonio Sancho-Muñoz,1,2 Joaquim Gea,1–3 Mauricio Orozco-Levi1–3 1Respiratory Medicine Department, Hospital del Mar-IMIM, Barcelona, Spain; 2Department CEXS, Universitat Pompeu Fabra, Barcelona, Spain; 3CIBERES, ISCIII, Barcelona, Spain; 4Department of Anesthesia, Hospital del Mar-IMIM, Barcelona, Spain; 5Universitat Autònoma de Barcelona, Barcelona, Spain Background: Hypercapnic encephalopathy is relatively frequent in severe exacerbations of COPD (ECOPDs), with its intensity usually being evaluated through clinical scales. Bispectral index (BIS) is a relatively new technique, based on the analysis of the electroencephalographic signal, which provides a good approximation to the level of consciousness, having already been validated in anesthesia. Objective: The objective of the study was to evaluate the utility of BIS in the assessment of the intensity of hypercapnic encephalopathy in ECOPD patients. Patients and methods: A total of ten ECOPD patients were included, and the level of brain activity was assessed using BIS and different scales: Glasgow Coma Scale, Ramsay Sedation Scale (RSS), and Richmond Agitation–Sedation Scale. The evaluation was performed both in the acute phase and 3 months after discharge. Results: BIS was recorded for a total of about 600 minutes. During ECOPD, BIS values ranged from 58.8 (95% CI: 48.6–69) for RSS score of 4 to 92.2 (95% CI: 90.1–94.3) for RSS score of 2. A significant correlation was observed between values obtained with BIS and those from the three scales, although the best fit was for RSS, followed by Glasgow and Richmond (r=-0.757, r=0.701, and r=0.615, respectively; P<0.001 for all). In the stable phase after discharge, BIS showed values considered as normal for a wake state (94.6; 95% CI: 91.7–97.9). Conclusion: BIS may be useful for the objective early detection and automatic monitoring of the intensity of hypercapnic encephalopathy in ECOPD, facilitating the early detection and follow-up of this condition, which may avoid management problems in these patients. Keywords: bispectral index, hypercapnic encephalopathy, exacerbation, COPD |
| first_indexed | 2024-12-13T04:46:56Z |
| format | Article |
| id | doaj.art-48b1a477707a423691395822b0730e7d |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-13T04:46:56Z |
| publishDate | 2018-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-48b1a477707a423691395822b0730e7d2022-12-21T23:59:07ZengDove Medical PressInternational Journal of COPD1178-20052018-09-01Volume 132961296740908Bispectral index in hypercapnic encephalopathy associated with COPD exacerbation: a pilot studyChalela RGallart LPascual-Guardia SSancho-Muñoz AGea JOrozco-Levi MRoberto Chalela,1–3 Lluis Gallart,4,5 Sergi Pascual-Guardia,1–3 Antonio Sancho-Muñoz,1,2 Joaquim Gea,1–3 Mauricio Orozco-Levi1–3 1Respiratory Medicine Department, Hospital del Mar-IMIM, Barcelona, Spain; 2Department CEXS, Universitat Pompeu Fabra, Barcelona, Spain; 3CIBERES, ISCIII, Barcelona, Spain; 4Department of Anesthesia, Hospital del Mar-IMIM, Barcelona, Spain; 5Universitat Autònoma de Barcelona, Barcelona, Spain Background: Hypercapnic encephalopathy is relatively frequent in severe exacerbations of COPD (ECOPDs), with its intensity usually being evaluated through clinical scales. Bispectral index (BIS) is a relatively new technique, based on the analysis of the electroencephalographic signal, which provides a good approximation to the level of consciousness, having already been validated in anesthesia. Objective: The objective of the study was to evaluate the utility of BIS in the assessment of the intensity of hypercapnic encephalopathy in ECOPD patients. Patients and methods: A total of ten ECOPD patients were included, and the level of brain activity was assessed using BIS and different scales: Glasgow Coma Scale, Ramsay Sedation Scale (RSS), and Richmond Agitation–Sedation Scale. The evaluation was performed both in the acute phase and 3 months after discharge. Results: BIS was recorded for a total of about 600 minutes. During ECOPD, BIS values ranged from 58.8 (95% CI: 48.6–69) for RSS score of 4 to 92.2 (95% CI: 90.1–94.3) for RSS score of 2. A significant correlation was observed between values obtained with BIS and those from the three scales, although the best fit was for RSS, followed by Glasgow and Richmond (r=-0.757, r=0.701, and r=0.615, respectively; P<0.001 for all). In the stable phase after discharge, BIS showed values considered as normal for a wake state (94.6; 95% CI: 91.7–97.9). Conclusion: BIS may be useful for the objective early detection and automatic monitoring of the intensity of hypercapnic encephalopathy in ECOPD, facilitating the early detection and follow-up of this condition, which may avoid management problems in these patients. Keywords: bispectral index, hypercapnic encephalopathy, exacerbation, COPDhttps://www.dovepress.com/bispectral-index-in-hypercapnic-encephalopathy-associated-with-copd-ex-peer-reviewed-article-COPDBispectral IndexHypercapnic encephalopathyExacerbationCOPD |
| spellingShingle | Chalela R Gallart L Pascual-Guardia S Sancho-Muñoz A Gea J Orozco-Levi M Bispectral index in hypercapnic encephalopathy associated with COPD exacerbation: a pilot study International Journal of COPD Bispectral Index Hypercapnic encephalopathy Exacerbation COPD |
| title | Bispectral index in hypercapnic encephalopathy associated with COPD exacerbation: a pilot study |
| title_full | Bispectral index in hypercapnic encephalopathy associated with COPD exacerbation: a pilot study |
| title_fullStr | Bispectral index in hypercapnic encephalopathy associated with COPD exacerbation: a pilot study |
| title_full_unstemmed | Bispectral index in hypercapnic encephalopathy associated with COPD exacerbation: a pilot study |
| title_short | Bispectral index in hypercapnic encephalopathy associated with COPD exacerbation: a pilot study |
| title_sort | bispectral index in hypercapnic encephalopathy associated with copd exacerbation a pilot study |
| topic | Bispectral Index Hypercapnic encephalopathy Exacerbation COPD |
| url | https://www.dovepress.com/bispectral-index-in-hypercapnic-encephalopathy-associated-with-copd-ex-peer-reviewed-article-COPD |
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