BIS monitor during organ retrieval

Started by wannabe, July 05, 2010, 01:40:28 AM

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This case happened a couple of years ago but still puzzles me. I was doing the usual 3 am organ harvest for a patient who had suffered a major intracranial hemorrage. She had all the usual brain stem tests and imaging and was declared brain dead by two intensivists. I attached a BIS monitor purely out of interest after we had started.  I generally give muscle relaxants antibiotics etc and only use vaporizers as a method to control hypertension. Interestingly the BIS readings varied between 40 and 70 which surprised me. I don't profess to understand the workings of the BIS but realise it can be affected by muscle tone and other artefacts but this pattern was consistent despite full muscle paralysis. The readings only dropped at the point when they x clamp and perfuse the liver prior to removal. I am not suggesting the patient wasnt brain dead but i was confused by the monitor which I did my best to ignore. Any opionins?? 


I just realized that this section is for upcoming not old cases!! Anyway I did just read an abstract showing artefacts both with bis and entropy in brain dead patients so I'm not alone.