Bis values fall with initial anaesthetic induction then rise as the patient emerges. Page 7 preface manual purpose this manual contains the instructions necessary to operate the product safely and in accordance with its function and intended use. The bis monitor is the first quantitative eeg index introduced into clinical. This patient monitor is designed to monitor a fixed set of physiological parameters including ecg, heart rate hr, respiration resp, temperature temp, spo2, pulse rate pr, noninvasive blood pressure nibp, invasive blood pressure ibp, cardiac output c. You can manage this and all other alerts in my account. The objective of the study is to determine wether the use of the bispectral index monitor bis as a method to guide anaesthesia for children in different groups of age, undergoing ear nose and throat surgery anaesthetized with an infusion of propofol and remifentanil with an high dose of remifentanil 0,52 mcgkgmin, can lead to a reduction in the time needed for extubation and in the. Page 1 service information manual aspect medical systems, inc. The bis has been validated as a measure of the hypnotic depth of anesthesia 16,17 and can reduce the risk of awareness. Mindray beneheart d3 operators manual pdf download. Bispectral index under propofol anesthesia in children. Called the bispectral index bis monitor, this noninvasive device can be used without assistance from highly specialized clinicians. Triltsch and colleagues attempted to correlate bis scores with a commonly used clinical sedation scoring system.
The use of bispectral index bis as a marker of sleep. A bispectral index bis monitor is commonly utilized to assess depth of sedation when administering sedative, hypnotic, or anesthetic agents during surgical. Bispectral index bis monitoring of icu patients on continuous infusions of sedatives and paralytics reduces sedative. It is derived utilizing a composite of measures from eeg signal processing techniques including bispectral analysis, power spectral analysis, and. Bispectral index monitor ontario healthtechnology assessment series 2004. A bispectral index bis monitor is commonly utilized to assess depth of sedation when administering sedative, hypnotic, or anesthetic agents during surgical and medical procedures. It provides depth of consciousness and sedation monitoring for use in the or, icu, and other clinical settings. Spectrumspectrum or service manual 007010055602 v foreword introduction foreword the spectrumspectrum or service manual is intended as a guide for technically qualified personnel during repair and calibration procedures. Spacelabs 993 xprezzon is a high acuity modular monitor suited for adult, pediatric, and neonatal. The a2000 processes raw eeg signals to produce a single number, called the bispectral index, or bis, which correlates to the. Use of bispectral index bis for monitoring of total. The use of clinical signs may not be reliable in measuring the hypnotic component of anaesthesia.
Bispectral analysis is a signal processing methodology that. The bispectral index declines during neuromuscular block. The bispectral index bis is a parameter which reflects brain electrical activity eeg in a range of values between 0 au minimum value, no eeg and 100 au. Background awareness during anesthesia is a serious complication with potential longterm psychological consequences. Bispectral index monitoring for early detection of brain death. M1034a bispectral index bistm2 additional plugin modules available are. The s5 compact anesthesia monitor with lcane05 or lcane05a software is indicated for monitoring of hemodynamic including arrhythmia and stsegment analysis, respiratory, ventilatory, gastrointestinalregional perfusion, bispectral index bis, entropy state entropy and. Subjects were randomly assigned to a bispectral index bisguided target range 4060 or to a weightrelated 2 mg. Bispectral index bis monitoring level of consciousness with the compact bisx power link philips bispectral index bis measurement uses aspect medical systems xp platform technology.
Bis can act as a reliable guide to monitor and titrate sedation and. The xprezzon provides easy access to patient data, creating information at the. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks. The bispectral index bis, aspect medical systems, natick, ma is a complex parameter, composed of a combination of time domain, frequency domain, and high order spectral subparameters 5. Bis monitors are intended to replace or supplement guedels classification system for determining depth of anaesthesia.
Bispectral index values and spectral edge frequency at diffe. The bis vista monitoring system is a user configurable patient monitoring system designed to monitor the hypnotic state of the brain based on acquisition and processing of eeg signals. Bispectral index monitoring, bis, general anesthesia, pediatric dentistry, sedation. The bispectral index bis depth of anaesthesia monitor is therefore recommended as an option in these patients. The use of bispectral index monitors in paediatric intensive care. In technical terms, the bispectral index itself is a complex mathematical algorithm that allows a computer inside an. Bispectral index bis monitoring standard of practice icu. Email bispectral index and lower margin amplitude of the amplitudeintegrated electroencephalogram in neonates. The bis view system processes raw eeg signals to produce a single number, called the bispectral index, or bis, which correlates with the patients level of hypnosis. One version of the processed eeg is the bispectral index bis. Bispectral index, bis, covidien cerebral function monitor intraoperative awareness under anesthesia also useful when sedatives administered icu.
Bispectral index bis monitoring is one of several technologies which monitor depth of anaesthesia. Bispectral index monitoring bis is a continuously processed eeg measure to assess depth of anaesthesia 29. Pdf bispectral index monitoring for early detection of. The monitors can be connected to the philips multimeasurement module mms family. This article explains how bis monitoring works and describes the authors experience with bis monitoring in patients undergoing elective synchronized electrical cardioversion. The bispectral index bis is one of several systems used in anesthesiology as of 2003 to measure the effects of specific anesthetic drugs on the brain and to track changes in the patients level of sedation or hypnosis. The dm4 monitor combines the simple performance of a spotcheck monitor with the sophistication of continuous monitoring, providing caregivers with a versatile solution for accurately and efficiently monitoring basic vital signs on adult, pediatric, and neonate patients. Bispectral index monitoring in ischemichypoxic brain injury. We have 3 mindray benevision n22 manuals available for free pdf download. Bis index values are the result of two particular innovations. Bispectral index versus comfort score to determine the level of sedation in paediatric intensive care unit patients. Identify potential limitations to using bis monitors for monitoring of sedation in.
Bispectral index monitoring and intraoperative awareness. It consists of a sensor, a digital signal converter, and a monitor. No related manuals summary of contents for aspect bis vista. Aspect medical systems, newton, ma, which incorporates the power spectrumfrequency and time and domainsand bicoherence of the raw eeg signal 4,16. The bis complete system processes raw eeg signals to produce a single number, called the bispectral index, or bis. The bispectral index bis is a processed electroencephalogram eeg monitor that measures the hypnotic effects of anesthetics and sedatives. Bis view monitoring system franks hospital workshop. Bis monitors are used to supplement guedels classification system for determining depth of anesthesia. Bispectral index monitoring basics article nursingcenter.
Diagnostic and prognostic use of bispectral index in coma. Bispectral index, electroencephalography, coma, vegetative state, minimally conscious state, brain injury introduction the assessment of consciousness level in severely brain damaged patients represents a real challenge. Bispectral index bis is a dimensionless variable between 0 and 100 that correlates with the degree of sedation 14. Bispectral index for improving anaesthetic delivery and. It is unique among the quantitative electroencephalogram qeeg parameters because it integrates several independent descriptors of the eeg into a single variable. Mindray beneview t5 download your lost manuals for free. The bispectral index bisx module acquires realtime electroencephalogram eeg. In the operating room or critical care environments, the bisx module reliably monitors. Practice patterns in the intraoperative use of bispectral. Titrating anesthetic agents to a specific bispectral index during general anesthesia in adults and children over 1 year old allows the anesthetist.
The bispectral index bis is a processed electroencephalogram eeg monitor that. Bispectral index bis and spectral edge frequency sef are used as measures of depth of anesthesia and sedation. All future purchases should be made directly through covidien. Bispectral index bis monitoring system rx only ec rep aspect medical systems, inc. Today, the bis index remains the most validated form of consciousness or brain function monitoring used within the clinical context of anesthesia and sedation care. Bispectral index monitoring is a useful tool to accomplish this, because it can provide objective information as to the degree of sedation in these critically injured patients. Using bispectral index monitoring to gauge depth of sedation. Bispectral index monitor ontario health technology assessment series 2004. Observance of this manual is a prerequisite for proper product performance and correct operation and ensures patient and operator safety.
Intellivue mx800 patient monitor philips 865240 technical data sheet the philips intellivue mx800 patient monitor offers a flexible and modular monitoring solution, designed to suit a broad spectrum of needs. The bispectral index is a processed electroencephalogrambased parameter used in critically ill adults for assessment of level of consciousness and response to sedative, hypnotic, and anesthetic agents. We tested whether these signals could predict physiologic sleep stages, by taking processed electroencephalogram measurements and recording full polysomnography through a nights sleep in 10 subjects being investigated for mild sleep apneahypopnea syndrome. The bispectral index bis monitor is a passive analyzer of eeg that provides surrogated measures of the hypnotic level.
Responsibility of the manufacturer ge healthcare finland oy ge is responsible for the safety, reliability and performance of the product only if. The study was conducted in 14 patients being investigated for sleep apneahypopnea syndrome osa. Monitoring consciousness using the bispectral index during. Then, the bisx analysis is calculated from the frequency, power, and phase throughout the entire frequency range of the eeg and presented as an index number between 1 and 100. A new closedloop control system for isoflurane using.
A computer search of englishlanguage articles in medline 1966july 2005. Update on bispectral index monitoring sciencedirect. Quantitative analyses are commonly employed to guide eeg interpretation. The monitor can be connected to the philips multimeasurement module mms family with its extensions, plugin. Bis allows hypnotic titration over the complete range of. Aspect medical systems a2000 bis monitoring system is a user configurable patient monitoring system designed to monitor the hypnotic state of the brain based on acquisition and processing of eeg signals. Depth of anaesthesia monitors bispectral index bis, e. This publication may have been updated to reflect product design changes andor manual improvements. Bispectral index bis monitoring systems allow anesthesia professionals the ability to access processed eeg information as a measure of the effect of certain. All patients that are receiving neuromuscular blockade. The monitor is menudriven with fixed keys for choosing the options available. Jul 27, 2016 the aim of this study was to compare bispectral index bis profiles percentage of time spent at adequate bis values between four modes of propofol infusion.
Sedation will not be discontinued on any patient with neuromuscular blockade based solely on bis monitor readings. Bispectral index bis monitoring standard of practice icu indications for use. The use of bispectral index bis to guide the dose of anaesthetic may have certain advantages over clinical signs. Operators manual, service manual, quick reference manual.
Subjects were randomly assigned to a bispectral index bisguided. Originally, the device was approved only for monitoring hypnosis and has now received an indication for reducing the incidence of intraoperative awareness during anesthesia. Intellivue mp60mp70 patient monitor philips m8005a, m8007a technical data sheet the philips intellivue mp60 and mp70 patient monitors offer a flexible and modular monitoring solution, designed to suit a broad spectrum of needs. The bis monitor is the first quantitative eeg index introduced into clinical practice as a monitor to assess the depth of anesthesia. Bispectral index bis is the most widely utilized technology that uses electroencephalogram to provide a measurement of anesthetic depth. The bis monitor reports a single number from 0 to 100 that represents an integrated measure of cerebral electrical activity. Atotw 416 bispectral index monitoring and intraoperative awareness 31 december 2019 page 3 of 9. It operates from an ac power source of 100v to 240v, 4763hz, and provides a minimum 20 minutes of automatic backup battery power.
Name of blue advantage policy bispectral index monitoring. A randomized controlled trial of anesthesia guided by. The bispectral index bis monitoring system enables anesthesia professionals to access processed eeg information as a measure of the effect of certain anesthetics during patient care. The depth of sedation is calculated by measuring cerebral electric activity via an electroencephalogram eeg. Depth of anesthesia and bispectral index monitoring. Bispectral index bis monitoring system product guide personalize anesthetic dosing. The bispectral index is a statistically based, empirically derived complex parameter. Pdf email bispectral index and lower margin amplitude. Anesthesia awareness and the bispectral index nejm. Bispectral index bis values are generated from an empirically. It quantifies the relationship between those component waveforms generated from fourier transformation. Introduction the bis view monitoring system is a user configurable patient monitoring system designed to monitor the hypnotic state of the brain based on acquisition and processing of eeg signals. The clinical impact of monitoring with bis technology has been demonstrated in a variety of randomized controlled trials that have revealed the potential. Intellivue mp60mp70 patient monitor philips m8005a, m8007a technical data sheet the philips intellivue mp60 and mp70 patient.
As opposed to coma, patients in a vegetative state vs open their eyes, indicating restoration of sleep. Feedback submission product manuals service contract supplier change request cleaning instructions. M1116b thermal array recorder m1032a vuelink device interface. There are no definitive guidelines on when bis should be used. This article is within the scope of wikiproject neuroscience, a collaborative effort to improve the coverage of neuroscience on wikipedia. The bispectral index bis is a processed neurophysiological electroencephalographic parameter that may be used to evaluate the depth of sedation in critically ill children. The bispectral index bisx module acquires realtime electroencephalogram eeg data for adult and pediatric patients. Correlation between observational scales of sedation and. Bis technology measures only the hypnotic component of anesthesia. The bis vista system processes raw eeg signals to produce a single number, called the bispectral index, or bis, which correlates with the patients level of.
Bis allows hypnotic titration over the complete range of cortical activity 2. Bispectral index for titrating sedation in ards patients. We further assessed whether bis can be useful for identifying sleep and the difference between its stages. The bis index is a processed eeg parameter with extensive validation and demonstrated clinical utility. Compare the recommendations for the use of bispectral index bis monitors between the guidelines for painagitationdelirium and neuromuscular blockade. Using bispectral index monitoring to gauge depth of.
Bispectral index score bis correlates strongly with levels of sedation, and the technology is a validated and frequently used method of monitoring sedation within the anesthetic setting. The bis view system processes raw eeg signals to produce a single number, called the bispectral index, or bis, which correlates with the patients level of. Aspect bis vista service information manual pdf download. The primary endpoint was the incidence of hypotension following the administration of propofol. Electromyographic activity increases the bispectral index up to 98 during anesthesia masui 2007. In order to be covered by blue advantage the service shall be reasonable and necessary under title xviii of. All reports in the ontario health technology assessment series are freely available in pdf. It was approved by the food and drug administration for this use in late. To provide rigorous data on the neurocognitive outcomes associated with bisguided anesthesia, we conducted a randomized controlled trial of bisguided anesthesia vs standard anesthesia care using concentrationguided techniques. Bispectral index bis is one of several technologies used to monitor depth of anesthesia. The bis view monitoring system is a user configurable patient monitoring system designed to monitor the hypnotic state of the brain based on acquisition and processing of eeg signals.
Xprezzon features a variety of configurations to fit the unique space and needs of your clinical environment. Assessing the depth of anesthesia and reducing intraoperative awareness has become a focus of much technology development and research in the field of anesthesia. Concomitant assessment of depth of sedation by changes in bispectral index and changes in autonomic variables heart rate andor bp. The bispectral index monitor is connected to a sensor which is placed on the forehead of the patient. A new closedloop control system for isoflurane using bispectral index outperforms manual control you will receive an email whenever this article is corrected, updated, or cited in the literature. Bispectral index monitoring gives objective and reliable data where the nurse can base care from, instead of relying mainly from vital signs as well as subjective signs, and thus, pose lesser threats of both undersedation and oversedation. They were able to demonstrate good correlation during deep sedation and in cases where the electrical. Introduction of the bispectral index bis for anesthesia monitoring makes it important to analyze how the new method addresses the old problem of assessment of anesthetic depth. Sales of bisx sensors are limited to one box with the purchase of capital equipment. The bis is an empirical, statistically derived measurement. A detailed description of how the a2000 works is contained within section v of the a. The bis complete monitoring system is a user configurable patient monitoring system designed to monitor the hypnotic state of the brain based on acquisition and processing of eeg signals.1218 255 394 1231 1156 414 1318 343 73 1308 545 1215 426 453 248 310 378 261 340 121 42 1269 919 604 147 103 1131 661 1226 53 566 631 1376 1112 532