Usefulness of a processed electroencephalography monitoring during mechanical ventilation in a pediatric intensive care unit: a case report

Processed electroencephalographic monitoring (PEEGM) is widely used to monitor the anesthetic depth of surgical patients in real time.While maintaining appropriate sedation is essential for children undergoing mechanical ventilation, current insurance policies cover PEEGM only when administered by an anesthesiologist in an operating room.This case report describes a preschooler intubated for epiglottitis in a pediatric intensive care unit.Despite receiving continuous sedation, she experienced an accidental extubation on day 1, requiring immediate re-intubation and additional sedation.Subsequently, the sedation dosage was titrated based on PEEGM using the Bispectral Index (Medtronic), which was initiated immediately after re-intubation.Following this adjustment, she remained stable without further self-extubation or other adverse events, and was eventually discharged.This case suggests that PEEGM can be a valuable monitoring tool for ensuring stable sedation in children on mechanical ventilation, supporting its utility beyond operating rooms.