title: Bispectral index monitoring in subarachnoid hemorrhage-associated out-of hospital cardiac arrest.
abstract: Bispectral index (BIS) is a simple, noninvasive, and continuous electroencephalographic monitor that could reflect the level of consciousness.Initially, BIS was developed to measure the anesthetic depth during operation; now, BIS could be used as a predictor of neurologic outcome in postresuscitative care. We report a case that had out-of cardiac arrest due to subarachnoid hemorrhage, and we used BIS to monitor the patient's consciousness level. During observation, another episode of cardiac arrest occurred due to delayed cerebral ischemia–related cardiac depression. Low bispectral index and high suppression ratio represent decreasing brain activity suggestive hypoxic ischemic encephalopathy.This was confirmed by brain perfusion scan and standard electroencephalographic study. Using BIS, we can identify patients with poor neurologic outcome earlier, and treatment could be alleviated if prognosis is futile.
authors.affiliation: Department of Emergency Medicine, Taipei Medical University Hospital, Taipei City, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan. Electronic address: anyimilk@gmail.com.
authors.forename: An-Yi
authors.initials: AY
authors.lastname: Wang
authors.affiliation: Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Huang
authors.affiliation: Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
authors.forename: Wei-Tien
authors.initials: WT
authors.lastname: Chang
authors.affiliation: Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan; Department of Emergency Medicine, Lotung Poh-Ai Hospital, Yilan County, Taiwan.
authors.forename: Wen-Jone
authors.initials: WJ
authors.lastname: Chen
mesh_terms: D000368:Aged; D003244:Consciousness Disorders / Q000175:diagnosis* / Q000209:etiology; D004569:Electroencephalography; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology*; D013345:Subarachnoid Hemorrhage / Q000150:complications*