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Bispectral index in hypercapnic encephalopathy associated with COPD exacerbation: a pilot study

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dc.contributor.author Chalela Rengifo, Roberto José, 1985-
dc.contributor.author Gallart Gallego, Lluís
dc.contributor.author Pascual Guàrdia, Sergi, 1979-
dc.contributor.author Sancho Muñoz, Antonio
dc.contributor.author Gea Guiral, Joaquim
dc.contributor.author Orozco Levi, Mauricio
dc.date.accessioned 2019-05-03T07:53:46Z
dc.date.available 2019-05-03T07:53:46Z
dc.date.issued 2018
dc.identifier.citation 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. Int J Chron Obstruct Pulmon Dis. 2018; 13:2961. DOI 10.2147/COPD.S167020
dc.identifier.issn 1176-9106
dc.identifier.uri http://hdl.handle.net/10230/37168
dc.description.abstract 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.
dc.description.sponsorship We are thankful to Jonathan McFarland for his editing aid and to Mireia Admetllo and Camino Fernández for their help in collecting clinical data. This project was funded in part by SAF SAF2014-54371, CIBERES, BRN-Pla Armengol 2014, 2014SGR424, SEPAR 2015, and SEPAR Becario 2015.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher DOVE Medical Press
dc.relation.ispartof Int J Chron Obstruct Pulmon Dis. 2018; 13:2961
dc.rights © 2018 Chalela et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License (https://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.
dc.rights.uri https://creativecommons.org/licenses/by-nc/3.0/
dc.title Bispectral index in hypercapnic encephalopathy associated with COPD exacerbation: a pilot study
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.2147/COPD.S167020
dc.subject.keyword Bispectral index
dc.subject.keyword Hypercapnic encephalopathy
dc.subject.keyword Exacerbation
dc.subject.keyword COPD
dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/SAF2014-54371
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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