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Published on: January 20, 2023
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Sedation-Induced Burst Suppression Predicts Positive Outcome Following Traumatic Brain Injury
Joel Frohlich1, Micah A Johnson1, David L McArthur2
1Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.
Frontiers in Neurology
|January 10, 2022
Summary
Electroencephalogram (EEG) burst suppression may be neuroprotective in traumatic brain injury (TBI) patients. Higher burst suppression ratios (BSR) were linked to better 6-month outcomes, suggesting its use as a prognostic biomarker.
Area of Science:
- Neurology
- Intensive Care Medicine
- Neurophysiology
Background:
- Electroencephalogram (EEG) burst-suppression is a therapeutic state induced by sedatives in intensive care units (ICUs).
- Limited evidence exists on the association between sedation-induced burst suppression and patient outcomes, particularly in moderate-to-severe neurological conditions.
- Traumatic brain injury (TBI) survivors often experience altered neurological states requiring intensive monitoring.
Purpose of the Study:
- To investigate the relationship between sedation-induced burst suppression (SIBS) and patient outcomes.
- To determine if EEG burst suppression ratio (BSR) can predict outcomes in patients with moderate-to-severe TBI.
- To evaluate the prognostic value of SIBS in TBI patients.
Main Methods:
- Studied 32 patients recovering from coma after moderate-to-severe TBI.
- Measured maximum EEG burst suppression ratio (BSR) during periods of low responsiveness (Glasgow Coma Scale).
- Utilized multi-model inference to assess predictors of Glasgow Outcome Scale extended (GOSe) at discharge and 6 months.
Main Results:
- Maximum BSR was positively associated with 6-month outcomes (P = 0.022).
- BSR did not predict outcomes at hospital discharge.
- Mediation analysis showed no evidence of BSR mediating sedative effects (barbiturates, propofol) on outcomes.
Conclusions:
- Initial observational evidence suggests burst suppression may be neuroprotective in acute TBI.
- Sedation-induced burst suppression could serve as a useful prognostic biomarker in the ICU for TBI patients.
- Further research is warranted to confirm the neuroprotective role and clinical utility of SIBS in TBI management.
