Bispectral index as a predictor of unsalvageable traumatic brain injury.

Overview

PRIMARY OBJECTIVE: We aimed to assess the utility of bispectral index (BIS) monitoring to diagnose brain death (BD) in patients with severe traumatic brain injury (TBI). RESEARCH DESIGN AND METHODS: A prospective observational study was conducted for patients with severe TBI between 2012 and 2014. MAIN OUTCOMES AND RESULTS: This study included 62 patients with a mean age of 32.5 ± 10.5 years. Nine patients had BD on admission with a sustainable BIS value of 0. Fifty-three patients were not initially diagnosed with BD with BIS values of 2-56. Forty-four patients deteriorated to BD, and their respective BIS values progressively decreased to 0. Nine patients with mean BIS of 39.2 ± 9.0 recovered and were transferred to a specialized high dependency unit. BIS values showed positive correlation with the Glasgow Coma Score (GCS) on admission (r = 0.43, p = 0.001). Survivors had higher BIS values than those who were initially declared BD or those who died during the hospitalization course (p = 0.001). CONCLUSION: BIS values have a significant correlation with initial GCS and can assist in the early detection of BD in patients with severe acute TBI. Further larger studies are needed to support our findings.