Predictive Value of the Bispectral Index for Burst Suppression on Diagnostic Electroencephalogram During Drug-Induced Coma

Abstract

This study is the first to measure correlation and predictive value between BIS monitoring and diagnostic EEG for degree of EEG suppression and burst count in the adult population. Available statistic tests and graphing of variables from BIS and diagnostic EEG show strong correlation and predictive value between both monitoring technologies during drug-induced coma. These support using BIS value, SR, and burst count to predict degree of EEG suppression in real time for titrating metabolic suppression therapy.

Processed EEG from depth of anaesthesia monitors and seizures: A scoping review

“…The five burst suppression studies showed correlation between states of burst suppression as confirmed on conventional EEG, and BIS parameters [10,12,25,27,28]. Uniformly, a low BIS value and a high suppression ratio was associated with this state, representing a relative paucity of EEG activity and increasing percentages of the trace being isoelectric.…”

“…The suppression ratio (SR) is an estimate of the level of burst suppression (BS), describing the percentage of the preceding 63 second EEG trace that is isoelectric; a value of 0 having no isoelectric periods and 100 being entirely isoelectric. This correlates strongly in comparative studies to BS calculations taken from standard EEG recordings and compared against SR [10][11][12]. This review explores the evidence to date on the use of proprietary, processed EEG depth of anaesthesia monitors for the detection and monitoring of seizure activity.…”

“…Seven relevant observational cohort studies were found of which five were prospective [10,12,15,[25][26][27][28]. These attempted to answer varying hypotheses, chiefly comparison of epileptic activity pEEG data with conventional EEG or correlation with burst suppression rhythms as determined by conventional EEG techniques and specific scenarios.…”

Noninvasive monitoring technologies to identify discomfort and distressing symptoms in persons with limited communication at the end of life: a scoping review

“…Sedation indices measured by BIS correlated with those measured by standard EEG in the ICU [ 60 ]. BIS scores increased during painful procedures in patients with traumatic brain injury in the ICU [ 61 ].…”

“…In summary, limited research has been performed on the clinimetrics of BIS. The preliminary results showed that it may have the potential to detect pain and delirium, as well as to monitor sedation and sleep [ 60 – 64 ].…”