Can bispectral index be an early marker in the diagnosis of brain death?

The diagnosis of brain death is a clinical condition in which it is difficult to perform confirmatory tests due to the ineligible clinical status of the patient. Prior to confirmatory tests, the use of a BIS monitor to determine the time of brain death is important for organ transplants, cost-effectiveness and reducing stressful wait of the family.

This study aimed to use BIS monitoring for early detection of brain death.

BIS monitoring was performed in 12 patients who were clinically diagnosed with brain death in our intensive care unit during a two-year period.

All patients had diffuse brain injury. The BIS score was zero in all patients. However, two patients could not be legally diagnosed with brain death because confirmatory tests could not be performed due to the clinical status. In one patient, the BIS score was zero and blood flow was present on the first computed tomography angiography of the brain; however, the cerebral blood flow was absent on the second imaging after two days.

It was believed that BIS monitoring could be a parameter to use for detection of brain death in patients with severe brain injury. However, future research is needed in this regard.