Combined BIS And Serum Neuron-specific Enolase In The Predictive Value Of Acute Cerebral Function Change In Coma Patients

Background and Objective: The classification of patients in a coma is a medical emergency.The cause should be known and,where possible,rectified and the brain provided with the proper protection to reduce further damage.It then becomes important to tell those patients for whom the prognosis is helpless and in whom the institution or persistence of resuscitative measures is wrong,serving only to carry the anguish of relatives and carers.It is often the neurologist to whom the physicians turn,to open the prognosis of the individual in a coma.It is therefore outstanding that the neurologist in training practices a system whereby he or she can fairly and accurately determine those cause which helps in identifying prognosis and thereby useful reasonable advice to colleagues.The focus of the study was to investigate the prognostic value of the Bispectral index and serum neuron-specific enolase for Neurological outcome arranged according to the Pittsburgh cerebral performance category(CPC 1 to 5)after a week.The main objective of this study is to evaluate the prognostic value of the Bispectral index and neuron-specific enolase in the acute cerebral function change in coma patients.Method: In this research study,28 patients are studied which then classified under coma patients.Patients defined as unconscious,unresponsive,or having a Glasgow score ?8 were considered as comatose in our study.The average age parameter is used for division of neurological outcome and,further classified into Pittsburgh cerebral performance category(CPC: 1 to 5).In our study,total 13 male patients and 15 female patients in the age group between 48 to 92 years old(72.10±11.35)have been considered.The BIS and NSE serum values were recorded at 24 hour,72 hour and one week,respectively.Results: Eleven patients had a good neurological outcome with CPC score 1-3,and seventeen patients had a poor neurological outcome with CPC 4-5 at 3 months.Compared with good prognosis group,the NSE values were significantly higher in the poor prognosis group on day 1 to one week observation [24 hr:(71.2±39.6)72 hr:(87.7±49.5)ng/mL and one week:(96.3±42.1).P<0.05.NSE increased in the poor neurological outcome group from 24 hr to one week,and decreased significantly in the good group at the same time [?NSE 24 hr-72 hr:(11.3±7.5)ng/mL;?NSE 72 hr-one week:(6.1±1.10)ng/mL P<0.05].Over the one week of monitoring,the mean BIS values were lower in the poor prognosis group compared to the good prognosis group at 24 hr: [(53.76±14.27)vs.(58.63±12.10),72hr:(56.7±25.5)vs.(68.3±14.2),and one week:(63.1±27.3)vs.(84.18±13.2)P<0.05.Conclusion: In this study,NSE and BIS combined examination give the higher prognostic value of brain function and effective prognostic indicators for the acute cerebral function change in coma patients.