Aplication Research Of Closed Loop Of Target Controlled Infusion Feedback With Bispectral Index For Sedation Of ICU Patients

Object:To discuss the applicability and value of BIS which was to the patients who were required ventilation in ICU,in addition,to discuss the applicability and value of TCI and CLTCI which were to the patients who were required ventilation in ICUMethod:Thrity critical patients undergoing mechanical ventilation in ICU were randomly divided into three groups,and every group included 10 patients. Groupâ… was the group of propofol for sedation,and fentanyl for controlling pain with micro pump infusion,attempting to keep the patients' Ramsay score in the range from 2 to 4.Groupâ…¡was the group of propofol with TCI for sedation,and fentanyl with micro pump infusion for controlling pain,attempting to keep the patients' Ramsay score in the range from 2 to 4.Groupâ…¢was the group of propofol with CLTCI which target scope of BIS value was set-ted from 80 to 70 for sedation,and fentanyl with micro pump infusion for controlling pain.On condition of sedation,all patients were observated for 24 hours,set up the observational time point every 30 minutes interval,and noted MAP,RR,SPO2,HR,BIS value,Ramsay score,and the average consumption of propopol in each group for 24 hours.Results:After sedation therapy,the MAP of 3 groups were reduced comparing with the basic values,and the difference of MAP was significant in each group(P＜0.05).The extent of MAP reduction was no significant difference among groups(P＞0.05).There was no significant difference among HR,RR and SPO₂ comparing with the basic values in each group(P＞0.05).The correlation was proved between BIS and Ramsay score to each group,and the correlation was also proved between BIS and Ramsay score to all patients(n=30).The percent of time maintaining the patients on condition of ideal sedation was 69.16%,71.04%,80.21%,and there was a significant difference in groupâ…¢comparing withâ… andâ…¡(P＜0.05).The percent of time of BIS within the range from 80 to 70 was 48.54%,51.25%,65.20%,and there was a significant difference in groupâ…¢comparing withâ… andâ…¡(P＜0.05).The average consumption of propopol was 1332±176.43mg,1403±165.73mg, 1160±201.99mg,and the average consumption of propopol in groupâ…¢was less than others.(P＜0.05).Conclution:1.BIS was suitable for monitoring patients' sedation therapy.BIS was a obejective,convenient,obvious monitor,and had no damage and could monitor the state of sedation in real time.2.There was no difference between TCI and micro pump infusion to the effect of sedation,but TCI was better for titration of sedation.3 CLTCI was a better means of sedation comparing TCI and micro pump infusion,and it could provid ideal effect of sedation,lack the inadequate or excessive sedation, keep the basic stability of hemadynamics,and reduce the average consumption of propopol effectively.