BIS monitoring as an outcome predictor in severely brain damaged nonsedated critically ill patients

Valero, Ricard; Gambús, Pedro L.; Zavala, B.; E, Guix; Fàbregas, Neus

doi:10.1097/00003643-200100001-00246

Cited by 5 publications

(5 citation statements)

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“…6,7 A patient who has an isoelectric EEG indicating brain death will have a score of 0. Although bispectral index monitoring in confirmation of brain death has been anecdotally reported, [17][18][19] we have not found any case report or study on the confirmation of brain death in children in the literature. Watson et al and Gilbert et al showed a good correlation between the bispectral index and neurologic status in patients with unsedated coma.…”

Section: Discussionmentioning

confidence: 86%

“…22 In this study, Hsia et al showed a good correlation between the bispectral index score and the Glasgow Coma Scale score in critically ill children (P , .001; r 5 .76). Although bispectral index monitoring in confirmation of brain death has been anecdotally reported, [17][18][19] we have not found any case report or study on the confirmation of brain death in children in the literature. In our study, all of the patients had a bispectral index score of 0 and none of them survived.…”

Section: Discussionmentioning

confidence: 86%

“…12,13 Some studies indicate a good correlation between the bispectral index and neurologic status. [17][18][19] However, we have not found any case report or study on the confirmation of brain death in children in the literature. [17][18][19] However, we have not found any case report or study on the confirmation of brain death in children in the literature.…”

mentioning

confidence: 99%

“…[14][15][16] Bispectral index monitoring in the confirmation of brain death has been anecdotally reported. [17][18][19] However, we have not found any case report or study on the confirmation of brain death in children in the literature. Additionally, many pediatricians, including pediatric neurologists, are not sufficiently aware of the utility of bispectral index monitoring in the diagnosis of brain death in children.…”

mentioning

confidence: 99%

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Bispectral Index Monitoring in Confirmation of Brain Death in Children

Okuyaz

Birbiçer²,

Doruk³

et al. 2006

J Child Neurol

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Although the guidelines for the diagnosis of brain death in children are well established, the diagnosis is still under debate, and further confirmatory tests are required. Performing these confirmatory tests presents some drawbacks, such as high costs, the need for specialized personnel and technology, transportation of patients out of the intensive care unit, and the use of contrast media. Bispectral index monitoring can provide real-time, objective, continuous monitoring of the consciousness level in critically ill children. The aim of this prospective study was to define the role of bispectral index monitoring in the confirmation and diagnosis of brain death. Eight children who had fulfilled the diagnostic criteria of brain death were included in the study. The age of patients ranged from 3 months to 15 years. All patients had electrocerebral silence on their electroencephalographic recordings. After the diagnosis of brain death, at least 2-hour monitoring was performed, and all patients expressed a score of 0, indicating brain death. According to our study, the decrease in bispectral index score to 0 in patients with suspected brain death can support and confirm brain death diagnosis in children and can enable scheduling of expensive tests, such as cerebral angiography, in the appropriate time. Nevertheless, further studies are needed to determine the role of the bispectral index in the diagnosis and confirmation of brain death in children. In this article, we review clinical utility, application time, and interpretation of bispectral index monitoring in confirmation of brain death diagnosis in children.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 86%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Bispectral Index Monitoring in Confirmation of Brain Death in Children

Okuyaz

Birbiçer²,

Doruk³

et al. 2006

J Child Neurol

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“…Valero et al found that BIS levels were different in brain-injured patients who survived compared to those who died. 16 Vivien concluded that the BIS can be used in comatose patients as an assessment of brain death onset, prompting further studies to confirm brain death. 17 Even though there may be a relationship between low BIS values and poor outcome, no prospective, randomized trials support this association.…”

Section: Use In Critical Care Unitsmentioning

confidence: 99%

BIS Monitoring: Awareness and Catastrophic Events

Adam

Sebel

2004

Semin Cardiothorac Vasc Anesth

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The bispectral index is an electroencephalogram-based monitoring tool to help anesthesiologists determine depth of anesthesia. The bispectral index indicates both the potential for awareness and of relative hypnotic overdose, but it does not predict movement or hemodynamic responses to stimulation, and it cannot predict the exact moment consciousness returns. The bispectral index has been assessed for its relationship to awareness, and bispectral index monitoring appears to be generally associated with a low incidence of awareness. The bispectral index has also has been noted to detect periods of cerebral ischemia. It is also being used in intensive care units to help quantify the level of sedation in patients and as an outcome predictor in patients with brain injuries. Low values of the bispectral index often occur during catastrophic, ischemic, events but the use of this technology for the routine monitoring of such events is unproven.

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