When the Bispectral Index (Bis) can Give False Results

Duarte, Leonardo Teixeira Domingues; Saraiva, Renato Ângelo

doi:10.1590/s0034-70942009000100013

Cited by 44 publications

(48 citation statements)

References 51 publications

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“…Since the brain is the effect-site of anesthetic drugs, commercially available anesthetic depth indicators employ different algorithms based on the analysis of spectral changes in electroencephalogram (EEG) [2]. However, this may give rise to erroneous DOA estimates in patients with abnormal EEG [3]. For instance, the bispectral index (BIS), a widely used anesthetic depth monitor, has been reported to underestimate or overestimate anesthetic depth in many clinical scenarios [3].…”

Section: Introductionmentioning

confidence: 99%

“…However, this may give rise to erroneous DOA estimates in patients with abnormal EEG [3]. For instance, the bispectral index (BIS), a widely used anesthetic depth monitor, has been reported to underestimate or overestimate anesthetic depth in many clinical scenarios [3]. Anesthetic drugs inhibit neuronal activity in the brain and affect cerebral metabolism [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Monitoring of cerebral oxygenation and local field potential with a variation of isoflurane concentration in a rat model

Choi

Shin

Kim

et al. 2016

Biomed. Opt. Express

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Abstract:We aimed to investigate experimentally how anesthetic levels affect cerebral metabolism measured by near-infrared spectroscopy (NIRS) and to identify a robust marker among NIRS parameters to discriminate various stages of anesthetic depth in rats under isoflurane anesthesia. In order to record the hemodynamic changes and local field potential (LFP) in the brain, fiber-optic cannulae and custom-made microelectrodes were implanted in the frontal cortex of the skull. The NIRS and LFP signals were continuously monitored before, during and after isoflurane anesthesia. As isoflurane concentration is reduced, the level of oxyhemoglobin and total hemoglobin concentrations of the frontal cortex decreased gradually, while deoxyhemoglobin increased. The reflectance ratio between 730nm and 850nm and burst suppression ratio (BSR) correspond similarly with the change of oxyhemoglobin during the variation of isoflurane concentration. These results suggest that NIRS signals in addition to EEG may provide a possibility of developing a new anesthetic depth index. . 12(4), 1019-1029 (1996). 15. S. Ahn, T. Nguyen, H. Jang, J. G. Kim, and S. C. Jun, "Exploring neuro-physiological correlates of drivers' mental fatigue caused by sleep deprivation using simultaneous EEG, ECG, and fNIRS data," Front. Hum. Neurosci. 10, 219 (2016). 16. J. G. Kim, J. Lee, J. Roe, B. J. Tromberg, M. Brenner, and T. J. Walters, "Hemodynamic changes in rat leg muscles during tourniquet-induced ischemia-reperfusion injury observed by near-infrared spectroscopy,"

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Monitoring of cerebral oxygenation and local field potential with a variation of isoflurane concentration in a rat model

Choi

Shin

Kim

et al. 2016

Biomed. Opt. Express

View full text Add to dashboard Cite

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“…BIS is a quantified parameter derived from EEG, and it provides a dimensionless number that varies from 0 to 100: 90-100 means a normal state; the lower the number below 90, the deeper the level of sedation; and 0 represents total suppression of cortical electrical activity. The FDA recommends the use of BIS to monitor the depth of anesthesia during surgery [3]. In recent years, the application of BIS has been more extensive, such as monitoring patients with epilepsy [4], and predicting prognosis of TBI [5,6-8].…”

Section: Resultsmentioning

confidence: 99%

“…BIS is also used as a tool to assess the sedation depth of TBI and guide the use of sedatives in some studies [3][4][5]. In this study, we presented a patient with refractory ICH due to TBI, and treated him with a combined strategy of sedation guided by BIS monitoring, ICP monitoring and mild hypothermia, a strategy producing a favorable outcome.…”

Section: Introductionmentioning

confidence: 99%

A Combined Strategy of Sedation Guided by Bispectral Index, ICP Monitoring and Mild Hypothermia to Deal with Refractory Intracranial Hypertension: A Case Report

Cao¹,

H²,

Wu³

et al. 2018

Brain Disord Ther

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Traumatic brain injury (TBI) has become a worldwide public health problem due to its high mortality and morbidity. Refractory intracranial hypertension (ICH), secondary to TBI, always results in poor prognosis and sometimes even death. Sedation, intracranial pressure (ICP) monitoring and mild hypothermia have been proven effective in monitoring and controlling ICH after TBI. Here we present a case of 55-year-old male suffering from acute TBI.

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“…The BIS is a weighted sum of several electroencephalographic (EEG) parameters [8] and its value decreases linearly with the increasing of the DOA. Unfortunately, also these techniques return wrong estimations in clinical situations due to abnormal EEG patterns or to different anesthetics or to interferences by other drugs [9]. Then, a system able to balance the DOA by administering drugs on the base of their actual concentration in patient's blood could be really attractive for better practice in anesthesiology.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous monitoring of anesthetics and therapeutic compounds with a portable multichannel potentiostat

Stradolini

ElBoshra

Biscontini

et al. 2016

2016 IEEE International Symposium on Circuits and Systems (ISCAS)

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Abstract-As metabolic pathways are highly variable among different patients, then an accurate and continuous monitoring of the personal response to drug treatments is essential especially with critical medications, e.g. anesthetic and anti-cancer cocktails. Currently, for anesthesia monitoring, there are no fully mature point-of-care bio-sensing systems. Indeed, it is still evaluated by mathematical models and with indirect parameters like Bispectral Index, which can not provide the actual concentration in blood.The aim of this paper is to investigate solutions for developing a portable system able to monitor simultaneously several different drugs. For this purpose, Cyclic Voltammetries with an anesthetic product and therapeutic compounds were performed for the validation of the system. A multichannel potentiostat has been realized with Off-The-Shelf Components (COTS). Then, results from electrochemical acquisitions on GC SPEs show that the proposed circuitry is suitable for this aim and they prove its high flexibility to develop portable systems for continuous monitoring of anesthetics and therapeutic compounds.

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When the Bispectral Index (Bis) can Give False Results

Cited by 44 publications

References 51 publications

Monitoring of cerebral oxygenation and local field potential with a variation of isoflurane concentration in a rat model

Monitoring of cerebral oxygenation and local field potential with a variation of isoflurane concentration in a rat model

A Combined Strategy of Sedation Guided by Bispectral Index, ICP Monitoring and Mild Hypothermia to Deal with Refractory Intracranial Hypertension: A Case Report

Simultaneous monitoring of anesthetics and therapeutic compounds with a portable multichannel potentiostat

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