Clinical application of BIS combined with LCR in assessing brain function and prognosis of patients with severe carbon monoxide poisoning

• Published in: Clinical neurology and neurosurgery Vol. 224; p. 107556
• Main Authors: Wang, Shuangbao, Liu, Yongjian, Liu, Huan, Wang, Pu, Wang, Weizhan
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2023; Elsevier Limited
• Subjects: Age; Bispectral index; Brain - diagnostic imaging; Brain damage; Brain Injuries; Brain nerve injury; Carbon monoxide; Carbon monoxide poisoning; Carbon Monoxide Poisoning - diagnosis; Carbon Monoxide Poisoning - therapy; Coma; Consciousness; Correlation analysis; Edema; Emergency medical care; Fecal incontinence; Gender; Hemoglobin; Humans; Hypoxia; Lactate clearance rate; Lactic Acid; Nervous system; Neurology; Patients; Poisoning; Prognosis; Regression analysis; Retrospective Studies; ROC Curve; United States > US; China; Bispectral index; Carbon monoxide poisoning; Prognosis; ASCOP; LCR; Lactate clearance rate; Brain nerve injury; CO; BIS
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2022.107556

This study investigated the value of the bispectral index (BIS) and lactate clearance rate (LCR) in the assessment of cerebral neurological injury and prognosis in acute severe carbon monoxide poisoning (ASCOP) patients. A retrospective study was conducted on 86 ASCOP patients admitted to our hospital from November 2019 to March 2021. The patients' prognosis neurological function of the brain after 3 months of treatment was observed. The patients were divided into good (48) and poor (38) groups according to the different prognoses. The GCS-Pittsburgh score (G-P score) was performed on the patients after admission. BIS and LCR were recorded at admission, 6 h, 24 h, 48 h, and 72 h after admission. We conducted correlation and multivariate regression analysis for each factor. ROC curves were used to assess the diagnostic efficacy of each index on prognosis. The two different prognosis groups showed that there were no significant differences for gender, age, treatment-free period, and APACHE II score at admission (P > 0.05); the G-P score, the BIS, and LCR at different times of admission was significantly higher in the good group than in the poor group (all P < 0.05). Both the 24 h of BIS and the LCR were diagnostically superior to the G-P score (P < 0.05); the diagnostic efficacy of the two combined was not superior to that of the individual factors (AUC=0.787), but had a high specificity (93.8 %). BIS monitoring and LCR have clinical value in the assessment of neurological damage and prognostic in ASCOP patients. •A retrospective study was conducted on 86 ASCOP patients according to the different prognoses.•The G-P score, BIS, and LCR at 4 time points were higher in the good prognosis group than in the poor group (P < 0.05).•Logistics regression analysis showed that G-P score, BIS value, and LCR independently influenced ASCOP prognosis.•BIS and blood LCR are critically important in assessing neurological damage and prognosis in ASCOP patients.