Manejo de la sedación en cuidados intensivos, correlación de dosis sedante guiada por BIS versus RASS. Revisión sistemática

Abstract

Objectives: To determine the correlation between Bispectral index (BIS)-guided sedation dosages and the RASS in critically ill patients in intensive care units. Methodology: Studies published in English and Spanish over the past 10 years, related to BIS- and RASS-guided sedation and adverse events, were included. Inaccessible studies or those in other languages were excluded. Databases such as Scopus, PubMed, and Web of Science were consulted, using keywords related to BIS, RASS, sedation, and intensive care, together with Boolean operators. In addition, validated tools, such as the Cochrane Risk of Bias Tool and the National Heart, Lung, and Blood Institute (NHLBI) were used to assess the methodological quality of the selected and included articles. Results: Monitoring with BIS optimized sedative dosing, reducing complications such as delirium and days of mechanical ventilation. RASS was effective in settings with limited resources and showed benefits in hemodynamic stability. Both methods achieved adequate levels of sedation, although BIS stood out for its precision and reduction of adverse effects. Conclusion: BIS and RASS are complementary approaches to sedation management in the Intensive Care Unit (ICU). While BIS excels in precision, RASS offers practicality and ease of use. Their combined implementation could improve clinical outcomes and optimize the care of critically ill patients, also promoting safe, efficient, and personalized care in intensive care units. Keywords: BIS, RASS, sedation in the ICU, sedative agents