Abstract
To discuss the effect of continuous monitoring of bispectral index (BIS) on the prognosis of patients with acute brain injury. A retrospective study was carried out, 61 patients with acute brain injury admitted to the intensive care unit (ICU) from March 2009 to July 2010 were divided into survival group (n=25) and death group (n=36). The BIS was continuously monitored for 12 hours within the first 3 days or 24 hours after stoppage of sedative after admission to ICU. The mean value of BIS (BISmean), the maximal value of BIS (BISmax), and the minimal value of BIS (BISmin) were evaluated. At the same time, the acute physiology and chronic health evaluationII (APACHEII) score, probability of survival (PS) and Glasgow coma score (GCS) were evaluated. The values of serum S100 protein and neuron-specific enolase (NSE) were determined. The relationship between BISmean and GCS, S100 protein and NSE were respectively analyzed. (1)There was no significant difference in the sex, age, or duration of mechanical ventilation between two groups. APACHEII score in death group was significantly higher than the survival group (27.36±5.99 vs. 23.28±6.69), PS was significantly lower than the survival group (0.31±0.17 vs. 0.49±0.19), and length of stay in ICU (days) was significantly lower than that of the survival group (6.33±4.48 vs. 27.88±54.46), P<0.05 or P<0.01. (2) BISmean, BISmax, BISmin, GCS in death group were significantly lower than those in the survival group (BISmean: 35.45±28.31 vs. 55.91±17.53, BISmax: 51.92±34.24 vs. 74.84±16.58, BISmin: 22.39±24.83 vs. 39.68±15.72, GCS score: 3.64±1.19 vs. 5.60±2.22), P<0.05 or P<0.01, while serum S100 protein and NSE levels were significantly higher than the survival group [S100 protein (μg/L): 7.54±10.49 vs. 1.18±1.57, NSE (μg/L): 120.74±109.01 vs. 49.83±54.94], both P<0.01. (3) By bivariate analysis, BISmean was positively correlated with GCS (r=0.379, P=0.003), whereas it was found to be negatively correlated with S100 protein and NSE levels (r₁=-0.418, P₁=0.001; r₂=-0.290, P₂=0.023). BIS monitoring can be applied as an early objective indicator to evaluate the prognosis of the acute brain injured patients with the characteristics of being noninvasive, intuitive, easy-to-manipulate, and non-stop monitoring.
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