Mahmood Saeed, El-Menyar Ayman, Shabana Amr, Mahmood Ismail, Asim Mohammad, Abdelrahman Husham, Al-Thani Hassan
a Trauma Surgery Section, Department of Surgery , Hamad General Hospital (HGH) , Doha , Qatar.
b Clinical Research, Trauma Surgery Section, Department of Surgery , HGH , Doha , Qatar.
Brain Inj. 2017;31(10):1382-1386. doi: 10.1080/02699052.2017.1330966. Epub 2017 Jun 28.
We aimed to assess the utility of bispectral index (BIS) monitoring to diagnose brain death (BD) in patients with severe traumatic brain injury (TBI).
A prospective observational study was conducted for patients with severe TBI between 2012 and 2014.
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).
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.
我们旨在评估脑电双频指数（BIS）监测在诊断重度创伤性脑损伤（TBI）患者脑死亡（BD）中的效用。
对2012年至2014年间的重度TBI患者进行了一项前瞻性观察研究。
本研究纳入了62例患者，平均年龄为32.5±10.5岁。9例患者入院时即脑死亡，其BIS值持续为0。53例患者最初未被诊断为脑死亡，BIS值为2 - 56。44例患者病情恶化至脑死亡，其各自的BIS值逐渐降至0。9例平均BIS为39.2±9.0的患者康复并被转至专门的高依赖病房。入院时BIS值与格拉斯哥昏迷评分（GCS）呈正相关（r = 0.43，p = 0.001）。幸存者的BIS值高于最初被宣布脑死亡或在住院期间死亡的患者（p = 0.001）。
BIS值与初始GCS显著相关，可协助早期检测重度急性TBI患者的脑死亡。需要进一步开展更大规模的研究来支持我们的发现。
