Bispectral index as a predictor of unsalvageable traumatic brain injury

Mahmood, Saeed; El‐Menyar, Ayman; Shabana, Amr; Mahmood, Ismail; Asim, Mohammad; Abdelrahman, Husham; Al-Thani, Hassan

doi:10.1080/02699052.2017.1330966

Cited by 14 publications

(10 citation statements)

References 21 publications

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“…This study showed that low BIS and GCS scores were significantly associated with adverse outcomes in comatose patients with severe brain injury. Our results are consistent with previous studies, which revealed that for patients with severe brain injury, the BIS value of patients who had a return of consciousness was significantly higher than that of those who did not (Mahmood et al, 2017), suggesting that BIS value had predictive prognosis value (Li et al, 2019). In addition, consistent with our study, Li et al (2019) found that BIS value was highly associated with GCS score, especially with a GCS score of less than 9, indicating that BIS was more sensitive in patients with severe brain injury (Mahadewa et al, 2018).…”

Section: Discussionsupporting

confidence: 93%

“…The BIS values reflect the activity of the cortical structure of the brain but do not reflect the activity of subcortical structures, such as the brain stem (Jain et al, 2020). Moreover, it was noticed that BIS value dropping to 0 (indicating no EEG activity) preceded the disappearance of spontaneous breathing in some patients who were later confirmed brain death by EEG and transcranial Doppler ultrasonography, which suggests that BIS could be used as a detector for brain death (Mahmood et al, 2017; Miao, Sun, Wang, & Li, 2018).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Prognosis of Coma Patients With Acute Brain Injury by Electroencephalogram Bispectral Index Monitoring

Shi

Shen

et al. 2021

Journal of Trauma Nursing

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Background: The high mortality rate of comatose patients with traumatic brain injury is a prominent public health issue that negatively impacts patients and their families. Objective, reliable tools are needed to guide treatment decisions and prioritize resources. Objective: This study aimed to evaluate the prognostic value of the bispectral index (BIS) in comatose patients with severe brain injury. Methods: This was a retrospective cohort study of 84 patients with severe brain injury and Glasgow Coma Scale (GCS) scores of 8 and less treated from January 2015 to June 2017. Sedatives were withheld at least 24 hr before BIS scoring. The BIS value, GCS scores, and Full Outline of UnResponsiveness (FOUR) were monitored hourly for 48 hr. Based on the Glasgow Outcome Scale (GOS) score, the patients were divided into poor (GOS score: 1–2) and good prognosis groups (GOS score: 3–5). The correlation between BIS and prognosis was analyzed by logistic regression, and the receiver operating characteristic curves were plotted. Results: The mean (SD) of the BIS value: 54.63 (11.76), p = .000; and GCS score: 5.76 (1.87), p = .000, were higher in the good prognosis group than in the poor prognosis group. Lower BIS values and GCS scores were correlated with poorer prognosis. Based on the area under the curve of receiver operating characteristic curves, the optimal diagnostic cutoff value of the BIS was 43.6, and the associated sensitivity and specificity were 85.4% and 74.4%, respectively. Conclusion: Taken together, our study indicates that BIS had good predictive value on prognosis. These findings suggested that BIS could be used to evaluate the severity and prognosis of severe brain injury.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Evaluation of Prognosis of Coma Patients With Acute Brain Injury by Electroencephalogram Bispectral Index Monitoring

Shi

Shen

et al. 2021

Journal of Trauma Nursing

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“…Data were recorded intraoperatively by downloading BIS values continuously to a laptop computer. Before anesthesia, the BIS sensor (BIS Quatro Sensor) was attached with four electrodes placed at an angle over the forehead of the patient, with values above 90 [ 17 ]. The incidence of nausea and vomiting after delivery, the need for a rescue antiemetic, BIS values, sedation scores, and the number of patients requiring intraoperative phenylephrine were assessed for the duration of surgery by research fellow B.…”

Section: Methodsmentioning

confidence: 99%

Use of propofol for prevention of post-delivery nausea during cesarean section: a double-blind, randomized, placebo-controlled trial

et al. 2018

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PurposeNausea and vomiting are common, undesirable symptoms during cesarean section. We conducted this study to assess the antiemetic properties of propofol for the prevention and immediate treatment of post-delivery nausea and vomiting during cesarean section under combined spinal–epidural anesthesia.MethodsEighty women undergoing elective cesarean delivery under combined spinal–epidural anesthesia were randomized to receive either propofol at a plasma concentration of 1000 ng/mL or normal saline immediately after clamping of the umbilical cord. The incidence of post-delivery nausea and vomiting, patients requiring rescue antiemetic, bispectral index, sedation score, and the incidence of hypotension were assessed intraoperatively. Satisfaction and neonatal behavioral neurological assessments were evaluated postoperatively.ResultsThe incidence of nausea was significantly lower in the propofol group compared to the placebo group (25% versus 60%, P < 0.001). The incidence of retching and vomiting showed no significant difference between the two groups. Propofol 20 mg as a rescue antiemetic was significantly effective in both the groups. Satisfaction level of patients and obstetricians in the propofol group was higher than in the placebo group. There was no statistical difference in the incidence of hypotension between the two groups both pre- and post-delivery. There was no difference in postoperative neonatal behavioral neurological assessment between groups.ConclusionPropofol at a plasma concentration of 1000 ng/mL significantly reduced the incidence of post-delivery nausea compared to placebo, but had no effect on reducing retching or vomiting episodes during cesarean section.

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“…They demonstrated that BIS values could correlate well with the prognosis of coma in the ICU (41). Subsequently, other investigators showed the BIS indices to correlate well with the prognosis of patients in coma and to assist with brain death determination in the comatose patients (41)(42)(43)(44). Some applications of BIS in the ICU are summarized in Table 2.…”

Section: Application Of Bis In the Icumentioning

confidence: 99%

“…Studies on patients with TBI have shown a significant correlation between BIS values and the levels of consciousness. BIS was found to be useful in monitoring the sedation level and the early detection of brain death in TBI patients (38,43,51,(53)(54)(55). Moghaddam et al monitored BIS for several days in patients with different brain injuries, such as cerebral contusion, subdural hemorrhage, and SAH.…”

Section: Application Of Bis In the Nccumentioning

confidence: 99%

A Review of Bispectral Index Utility in Neurocritical Care Patients

et al. 2020

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Context: Bispectral Index (BIS) was introduced in 1960 to monitor the depth of anesthesia in the operating rooms. It has been recently used to monitor the sedation in the critically ill patients hospitalized in intensive care and neurocritical care units (NCCU). Evidence Acquisition: Patients in the NCCU, particularly those with prolonged mechanical ventilation require appropriate adjustments in the administration of sedative drugs. Similarly, those who require neuro protection with barbiturates need to be closely monitored in the depth of their coma. Results: BIS may be a useful tool in this situation, and it can also help shorten the duration of mechanical ventilation by determining the appropriate time to eliminate patients from mechanical ventilation. We conducted a literature search to evaluate the utility of BIS monitoring in the NCCU patients with subarachnoid hemorrhage, intracranial hemorrhage, coma, cerebral hypoxia, status epilepticus and traumatic brain injury. Conclusions: BIS monitoring may be a useful adjunct to take care of the patients. However, further studies with a larger population and better design are required to substantiate the role of BIS monitoring in the care of NCCU patients.

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Bispectral index as a predictor of unsalvageable traumatic brain injury

Cited by 14 publications

References 21 publications

Evaluation of Prognosis of Coma Patients With Acute Brain Injury by Electroencephalogram Bispectral Index Monitoring

Evaluation of Prognosis of Coma Patients With Acute Brain Injury by Electroencephalogram Bispectral Index Monitoring

Use of propofol for prevention of post-delivery nausea during cesarean section: a double-blind, randomized, placebo-controlled trial

A Review of Bispectral Index Utility in Neurocritical Care Patients

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