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- W2035673896 abstract "To the Editor: Myles and Cairo (1) reported an unexpected increase in bispectral index values in a patient with ischemic brain injury, which was confirmed by cerebral angiography and attributed to electrocardiogram artifact. Gaszynski (2) refuted these findings and attributed them to “insular activity of the brain.” We observed similar findings to those of Myles and Cairo in a patient with a ruptured intracranial aneurysm in whom all the tests of brain death were positive. We have been using bispectral index as an adjuvant to diagnose brain death routinely in our intensive care unit. In the present case, we observed bispectral index values fluctuating between 0 and 50 with suppression ratio varying from 100% to 25% without any significant electromyographic activity on electromyographic strength indicator (Figs. 1–3). A careful analysis of the bispectral index monitor revealed that it was intermittently selecting electrocardiogram waveform and was falsely reading it as electroencephalogram (Fig. 4). Normally electrocardiogram and electromyographic artifacts are filtered by the bispectral index monitor, but in the present case it was actually selecting electrocardiogram tracings and they were corresponding to patient’s actual electrocardiogram tracings. Therefore, we recommend that electroencephalogram tracings should be carefully observed and the numerical values displayed on bispectral index monitor should not be relied on exclusively.Figure 1.Figure 2.Figure 3.Figure 4.G D. Puri, MD, PhD D. Nakra, MD Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical and Research Chandigarh, India [email protected]" @default.
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- W2035673896 date "2005-11-01" @default.
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- W2035673896 title "ECG Artifact and BIS in Severe Brain Injury" @default.
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- W2035673896 doi "https://doi.org/10.1213/01.ane.0000180375.64387.27" @default.
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