Decrease in Bispectral Index Preceding Signs of Impending Brain Death in Traumatic Brain Injury

2010 ◽  
Vol 22 (3) ◽  
pp. 268-269 ◽  
Author(s):  
Matthew M.J. Smith ◽  
John C. Andrzejowski
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Death ◽  
Bispectral Index

scholarly journals Early diagnosis of mortality using admission CT perfusion in severe traumatic brain injury patients (ACT-TBI): protocol for a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047305
Author(s):  
Susan Alcock ◽  
Divjeet Batoo ◽  
Sudharsana Rao Ande ◽  
Rob Grierson ◽  
Marco Essig ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Early Diagnosis ◽  
Hospital Mortality ◽  
Brain Death ◽  
Severe Traumatic Brain Injury ◽  
Health Research ◽  
Ct Perfusion ◽  
Severe Tbi

IntroductionSevere traumatic brain injury (TBI) is a catastrophic neurological condition with significant economic burden. Early in-hospital mortality (<48 hours) with severe TBI is estimated at 50%. Several clinical examinations exist to determine brain death; however, most are difficult to elicit in the acute setting in patients with severe TBI. Having a definitive assessment tool would help predict early in-hospital mortality in this population. CT perfusion (CTP) has shown promise diagnosing early in-hospital mortality in patients with severe TBI and other populations. The purpose of this study is to validate admission CTP features of brain death relative to the clinical examination outcome for characterizing early in-hospital mortality in patients with severe TBI.Methods and analysisThe Early Diagnosis of Mortality using Admission CT Perfusion in Severe Traumatic Brain Injury Patients study, is a prospective cohort study in patients with severe TBI funded by a grant from the Canadian Institute of Health Research. Adults aged 18 or older, with evidence of a severe TBI (Glasgow Coma Scale score ≤8 before initial resuscitation) and, on mechanical ventilation at the time of imaging are eligible. Patients will undergo CTP at the time of first imaging on their hospital admission. Admission CTP compares with the reference standard of an accepted bedside clinical assessment for brainstem function. Deferred consent will be used. The primary outcome is a binary outcome of mortality (dead) or survival (not dead) in the first 48 hours of admission. The planned sample size for achieving a sensitivity of 75% and a specificity of 95% with a CI of ±5% is 200 patients.Ethics and disseminationThis study has been approved by the University of Manitoba Health Research Ethics Board. The findings from our study will be disseminated through peer-reviewed journals and presentations at local rounds, national and international conferences. The public will be informed through forums at the end of the study.Trial registration numberNCT04318665

scholarly journals Characteristics of Hemodynamic Disorders in Patients with Severe Traumatic Brain Injury

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Ryta E. Rzheutskaya
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Death ◽  
Severe Traumatic Brain Injury ◽  
Transpulmonary Thermodilution ◽  
Hemodynamic Parameters ◽  
Central Hemodynamics ◽  
Close Study ◽  
Central Hemodynamic ◽  
Death Group

Purpose. To define specific features of central hemodynamic parameter changes in patients with isolated severe traumatic brain injury (STBI) and in patients with clinically established brain death and to determine the required course of treatment for their correction.Data and Research Methods. A close study of central hemodynamic parameters was undertaken. The study involved 13 patients with isolated STBI (group STBI) and 15 patients with isolated STBI and clinically established brain death (group STBI-BD). The parameters of central hemodynamics were researched applying transpulmonary thermodilution.Results. In the present study, various types of hemodynamic reaction (normodynamic, hyperdynamic, and hypodynamic) were identified in patients with isolated STBI in an acute period of traumatic disease. Hyperdynamic type of blood circulation was not observed in patients with isolated STBI and clinically established brain death. Detected hemodynamic disorders led to the correction of the ongoing therapy under the control of central hemodynamic parameters.Conclusions. Monitoring of parameters of central hemodynamics allows to detect the cause of disorders, to timely carry out the required correction, and to coordinate infusion, inotropic, and vasopressor therapy.

Brain tissue oxygenation in traumatic brain injury patients diagnosed with brain death

2013 ◽  
Vol 30 ◽  
pp. 105-105
Author(s):  
Hernandez M.J. Montero ◽  
R. Badenes ◽  
L. Alcover ◽  
L. Rovira ◽  
J. V. Llau ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Death ◽  
Brain Tissue ◽  
Tissue Oxygenation ◽  
Brain Tissue Oxygenation

scholarly journals S100B Protein May Detect Brain Death Development after Severe Traumatic Brain Injury

2013 ◽  
Vol 30 (20) ◽  
pp. 1762-1769 ◽  
Author(s):  
Juan J. Egea-Guerrero ◽  
Francisco Murillo-Cabezas ◽  
Elena Gordillo-Escobar ◽  
Ana Rodríguez-Rodríguez ◽  
Judy Enamorado-Enamorado ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Death ◽  
Severe Traumatic Brain Injury ◽  
S100b Protein

Bispectral index as a predictor of unsalvageable traumatic brain injury

Brain Injury ◽  
2017 ◽  
Vol 31 (10) ◽  
pp. 1382-1386 ◽  
Author(s):  
Saeed Mahmood ◽  
Ayman El-Menyar ◽  
Amr Shabana ◽  
Ismail Mahmood ◽  
Mohammad Asim ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Bispectral Index

scholarly journals Extended Glasgow Outcome Scale correlates with bispectral index in traumatic brain injury patients who underwent craniotomy

2018 ◽  
Vol Volume 10 ◽  
pp. 71-74 ◽  
Author(s):  
Tjokorda Gde Bagus Mahadewa ◽  
Tjokorda Gde Agung Senapathi ◽  
Made Wiryana ◽  
I Gusti Ngurah Mahaalit Aribawa ◽  
Ketut Yudi Arparitna ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Bispectral Index ◽  
Glasgow Outcome Scale

Brain Death After Severe Traumatic Brain Injury: The Role of Systemic Secondary Brain Insults

2005 ◽  
Vol 37 (5) ◽  
pp. 1990-1992 ◽  
Author(s):  
J.I. Sánchez-Olmedo ◽  
J.M. Flores-Cordero ◽  
M.D. Rincón-Ferrari ◽  
M. Pérez-Alé ◽  
M.A. Muñoz-Sánchez ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Death ◽  
Severe Traumatic Brain Injury ◽  
Brain Insults

scholarly journals Brain death rates in severe blunt traumatic brain injury: comparison of decompressive craniectomy to a medically managed cohort

2015 ◽  
Vol 42 (S1) ◽  
pp. S17-S17
Author(s):  
FA Zeiler ◽  
J Teitelbaum
Keyword(s):  
Traumatic Brain Injury ◽  
Cardiac Arrest ◽  
Brain Injury ◽  
Brain Death ◽  
Cause Of Death ◽  
Decompressive Craniectomy ◽  
Matched Cohort ◽  
Severity Scores ◽  
The Mean ◽  
The Impact

Introduction: Decompressive craniectomy (DC) in severe traumatic brain injury (TBI) is controversial. The impact DC on cause of death is unclear in the literature to date. Methods: We performed an institutional retrospective review, from June 2003 to June 2013, of patients with severe blunt TBI undergoing DC whom subsequently died. We compared this group to a retrospectively matched cohort based: age, pre-hospital mRS, Marshall diffuse and TBI grades, Injury Severity Scores, and admission laboratory values. The goal was to determine the cause of death between those receiving DC and those managed medically. Results: Nineteen patients received DC and were compared to 16 retrospectively matched patients. The mean age of the DC and matched cohort were 47.1 and 43.6 years, respectively. The mean admission GCS/Marshall diffuse CT grades were 5.8/3.4 for the DC group, and 4.1/3.1 for the matched medical cohort. Overall, in the DC group 94.7% of the deaths occurred secondary to cardiac arrest after withdrawal of life sustaining treatment (WLST), with only 5.3% progressing to brain death. Alternatively, in the matched cohort 62.5% died of cardiac arrest post WLST, with 37.5% progressing to brain death. Conclusions: Progression to brain death appears to be more common in those severe blunt TBI patients treated medically compared to those undergoing DC.

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