Bispectral index scores predicting complications after tracheal intubation

Background: Tracheal intubation is a procedure that may cause various complications. The primary aim of this study is to investigate whether the Bispectral Index (TM) (BIS) can predict tracheal intubation complications sooner than other monitoring parameters. Methods: A total of 55 consecutive patients were intubated. Sociodemographic data, the reason for tracheal intubation, diagnosis, starting dose or dose increase of a vasopressor drug, use of sedatives and muscle-relaxing agents, vital signs, BIS scores, and end-tidal CO2 values before the procedure, during laryngoscopy, and within 30 min after tracheal intubation were recorded along with their tracheal intubation-related complications. Results: The mean age of the patients was 75.1 +/- 14.4 years. Pneumonia (n = 17, 30.9%) and sepsis (n = 14, 25.5%) were found to be the two most prominent diagnoses. The most common indications for intubation were a low Glasgow Coma Scale score of <= 8 (67.3%) and respiratory failure (61.8%). Postintubation hemodynamic instability developed in 38 patients (69.1%).The BIS value obtained at minute 3 was the lowest among all measurements. Significantly lower values of BIS (minute 3) were found for patients with postintubation hemodynamic instability (46 vs. 72, p = 0.039). Using ketamine (OR = 8.99, 95% CI: 1.60-50.47, p = 0.013) and systoloc blood pressure (OR = 1.03, 95% CI: 1.01-1.05, p = 0.017) were found to be significant risk factors for the development of postintubation hemodynamic instability. Conclusion: In this study, the lowest BIS values were detected at minute three after intubation. The BIS values obtained at minute three were found to be significantly associated with the development of postintubation hemodynamic instability. (C) 2021 Elsevier Ltd. All rights reserved.