PubMed · 11652475
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
J D Hill. 1986-07-26. Personal view:. https://doi.org/10.1136/bmj.293.6541.264
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Explore the source record for details and available documents.
OBJECTIVES: To evaluate the accuracy of bispectral index (BIS) monitoring for the diagnosis of brain death in severely comatose patients. DESIGN: A prospective study in an intensive care unit of a university hospital. POPULATION: Fifty-six severely comatose patients (Glasgow Coma Score < or = 5) admitted to the ICU mainly because of intracerebral hemorrhage, head injury, or postanoxic coma. METHODS: BIS was recorded continuously during the hospitalization in the ICU. Where necessary, clinical brain death was confirmed by EEG or cerebral angiography. MEASUREMENTS AND RESULTS: Twelve patients were already clinically brain dead at the time of admission, and their individual BIS values were 0. In each of these 12 patients brain death was thereafter confirmed by EEG or cerebral angiography. Forty-four patients were not clinically brain-dead at the time of admission, and their individual BIS values were between 20 and 79. Twenty-seven of these patients became brain-dead, and their individual BIS values dropped to 0 in a few hours to a few days. In these 27 patients EEG or cerebral angiography was performed after the BIS value decreased to 0 and confirmed brain death in all cases. Seventeen patients who did not become brain dead during their hospitalization in the ICU had persistent electrocerebral activity on EEG, and their average BIS values remained above 35. CONCLUSION: BIS can be used in severely comatose patients as an assessment of brain death onset, enabling appropriate scheduling of either EEG or cerebral angiography to confirm brain death.
A method for simultaneous determination of glycerol and mannitol in various human tissues was devised and for this we used high-performance liquid chromatography (HPLC). Specimens were homogenized in a mixture of chloroform and methanol, phosphate buffer (pH 7.0) and pentaerythritol (IS) solution. After centrifugation, an aliquot of the aqueous layer was evaporated to dryness and derivatized with p-nitrobenzoyl chloride at 50 degrees C for 1h, then applied to HPLC with analytical conditions of: column, CAPCELL PAK C18 MG (250 mm x 3.0 mm i.d., 5 microm, Shiseido Co. Ltd., Tokyo, Japan); column temperature, 1-2 degrees C; mobile phase, 75% acetonitrile-distilled water containing 0.05% trifluoroacetic acid, 0.05% heptafluoro-n-butyric acid and 0.1% triethylamine; flow rate, 0.5 ml/min; wavelength, 260 nm. Calibration curves for both substances were linear in concentration ranges from 1 to 500 microg/0.1g and correlation coefficients exceeded 0.99. The relative standard deviation (R.S.D.) of the method was evaluated at concentrations of 10 and 100 microg/0.1g, and ranged from 0.84 to 10.6%. Using this method, we determined the regional distribution levels of glycerol and mannitol in various tissues from an autopsied brain dead man.