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Intensive Care Medicine

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01-02-2010 | Original

The bispectral index and suppression ratio are very early predictors of neurological outcome during therapeutic hypothermia after cardiac arrest

Authors: David B. Seder, Gilles L. Fraser, Tracy Robbins, Laurel Libby, Richard R. Riker

Published in: Intensive Care Medicine | Issue 2/2010

Abstract

Purpose

To evaluate the bispectral index (BIS) and suppression ratio (SR) as very early predictors of neurological outcome during therapeutic hypothermia after cardiac arrest.

Methods

Demographic data, BIS1, and SR1 were recorded from 97 patients after the first dose of neuromuscular blockade, with outcomes blinded, and compared to the discharge Cerebral Performance Category (CPC). Receiver-operator characteristic curves and a multiple logistic regression model were constructed to predict good (CPC 1-2, GO) and poor (CPC 3-5, PO) neurological outcomes.

Results

Fourteen patients were excluded from the final analysis; 33 of the remaining 83 patients (40%) were classified as GO. The BIS1 was higher in patients with GO (37 [28–40] vs. 7 [3–15], p < 0.001). BIS1 < 22 predicted PO with a likelihood ratio (LR) of 14.2 and an area under the curve (AUC) of 0.91 (95% CI 0.85–0.98, p < 0.001). SR1 ≥48 predicted PO with a LR of 12.7 and an AUC of 0.90 (95% CI 0.83–0.98, p < 0.001). Both BIS1 (ΔAUC 0.16, p = 0.006) and SR1 (ΔAUC 0.16, p = 0.005) predicted outcomes better than the time to return of spontaneous circulation.

Conclusions

In our single-center cohort utilizing moderate sedation, the bispectral index and suppression ratio recorded after the first dose of intermittent neuromuscular blockade were accurate and very early predictors of neurological outcome during therapeutic hypothermia after cardiac arrest.

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Title: The bispectral index and suppression ratio are very early predictors of neurological outcome during therapeutic hypothermia after cardiac arrest
Authors: David B. Seder
Gilles L. Fraser
Tracy Robbins
Laurel Libby
Richard R. Riker
Publication date: 01-02-2010
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 2/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1691-1

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Springer Medicine

The bispectral index and suppression ratio are very early predictors of neurological outcome during therapeutic hypothermia after cardiac arrest

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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