Bispectral Index Scale Variations in Patients Diagnosed With Brain Death

Fyntanidou, Barbara; Grosomanidis, Vasilios; Aidoni, Zoi; Thoma, Giannoula; Giakoumis, Marios; Kiurzieva, E.; Skourtis, C

doi:10.1016/j.transproceed.2012.09.012

Cited by 10 publications

(8 citation statements)

References 16 publications

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“…In many cases, persistently high BIS scores after brain death can be attributed to movement of the deceased patient by health care staff or to electrocardiographic activity, but in some cases, the reason cannot be found. [118][119][120] Thus, BIS may provide helpful information regarding the timing of herniation and progression to brain death, but it cannot replace existing, better-established ancillary tests.…”

Section: Other Potential Ancillary Testsmentioning

confidence: 99%

Ancillary Testing in Brain Death

Kramer

2015

Semin Neurol

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Despite worldwide acceptance of the concept of brain death, there is marked variability in the use of ancillary testing. In most countries, ancillary tests are used primarily when confounding factors interfere with reliable completion of a clinical assessment, or physiologic instability precludes performance of an apnea test. Alternatively, in some countries, confirmatory ancillary tests are routinely required before brain death can be diagnosed. Ancillary tests assess brain function (e.g., electroencephalography) or blood flow (e.g., cerebral angiography). Evaluation of blood flow is affected less by confounding clinical factors and is now preferred in most jurisdictions. With angiographic techniques, a significant proportion of patients meeting clinical criteria for brain death have some opacification of proximal intracranial arteries. Consequently, the sensitivity of angiography is strongly influenced by the particular criteria that are used to define intracranial circulatory arrest. Lack of enhancement of the great cerebral and internal cerebral veins has the highest sensitivity. Worldwide experience with newer tests, such as computed tomography and magnetic resonance angiography, is growing. Radionuclide imaging has the advantage of not requiring use of potentially nephrotoxic contrast material. Transcranial Doppler ultrasonography can be brought to the bedside to demonstrate lack of brain blood flow. The specificity of imaging techniques in the detection of intracranial circulatory arrest has not been as well studied as their sensitivity.

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Section: Other Potential Ancillary Testsmentioning

confidence: 99%

Ancillary Testing in Brain Death

Kramer

2015

Semin Neurol

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“…Immediately after surgery, SICH was diagnosed by CT. Although the BIS does not monitor the brainstem directly, it monitors the outside of the brainstem regionally and can be used for earlier detection of brain herniation or worsening cerebral activity [15].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous intracerebral hemorrhage during left hemihepatectomy in a cirrhotic patient

2019

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Spontaneous intracerebral hemorrhage (sICH) is bleeding that occurs without trauma or known structural abnormality. Hypertension is a main cause of sICH, but liver cirrhosis may be another reason; however, this rarely occurs under anesthesia. We report on a case of sICH in a 75-yearold woman patient with liver cirrhosis during left hemihepatectomy. And the literature on the usefulness of perioperative bispectral index monitoring for early detection of brain damage is reviewed.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…As a method for identifying outliers in the EEG signal, the FBP could be used to rapidly identify periods of an EEG recording that show high likelihood for contamination by artifacts. In clinical applications, the continuous EEG recording has demonstrated promise as a method for monitoring neural function in patients who have compromised level of consciousness (Fyntanidou et al, 2012 ) or changes in neural function in patients undergoing neurosurgical interventions (de Vos et al, 2008 ). The use of FBP to identify outliers in the EEG recording represents a novel method for determining periods of the EEG recording that represent changes in consciousness in patients with a compromised level of consciousness, or for determining changes in neural function across neurosurgical intervention.…”

Section: Discussionmentioning

confidence: 99%

An exploratory data analysis of electroencephalograms using the functional boxplots approach

et al. 2015

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Many model-based methods have been developed over the last several decades for analysis of electroencephalograms (EEGs) in order to understand electrical neural data. In this work, we propose to use the functional boxplot (FBP) to analyze log periodograms of EEG time series data in the spectral domain. The functional bloxplot approach produces a median curve—which is not equivalent to connecting medians obtained from frequency-specific boxplots. In addition, this approach identifies a functional median, summarizes variability, and detects potential outliers. By extending FBPs analysis from one-dimensional curves to surfaces, surface boxplots are also used to explore the variation of the spectral power for the alpha (8–12 Hz) and beta (16–32 Hz) frequency bands across the brain cortical surface. By using rank-based nonparametric tests, we also investigate the stationarity of EEG traces across an exam acquired during resting-state by comparing the spectrum during the early vs. late phases of a single resting-state EEG exam.

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Bispectral Index Scale Variations in Patients Diagnosed With Brain Death

Cited by 10 publications

References 16 publications

Ancillary Testing in Brain Death

Ancillary Testing in Brain Death

Spontaneous intracerebral hemorrhage during left hemihepatectomy in a cirrhotic patient

An exploratory data analysis of electroencephalograms using the functional boxplots approach

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