Brain death is the irreversible and complete loss of cerebral function leading to extinction of brain impulses necessary to sustain life. Its diagnosis is based on the absence of brainstem reflexes and the exclusion of endo- or exogenous factors confounding the clinical presentation [1]. With advances in intensive care medicine and the emergence of organ donation programs worldwide, early and reliable diagnosis of brain death is gaining importance [www.irodat.org]. Howeve, the predefined technical requirements as well as the qualification and number of clinicians to be involved in the diagnostic workup is inconsistent worldwide. This issue is mirrored by an international review, revealing that the conduct of apnea tests, the time to brain death diagnosis, the number of required examiners, and predefined clinical scenarios calling for ancillary tests varied among countries [2]. This variability in combination with the lack of systematic studies regarding the frequency and presentation of specific reversible clinical conditions mimicking brain death further challenge clinicians and put patients at risk.
Are there any systematic studies regarding the frequency and type of clinical conditions mimicking brain death and the reliability of diagnostic procedures when cerebral death is suspected?
1. Wijdicks EF. The diagnosis of brain death. N Engl J Med 2001;344(16):1215-1221.
2. Wijdicks EF. Brain death worldwide: accepted fact but no global consensus in diagnostic criteria. Neurology 2002;58(1):20-25.
I am as a nurse transplant coordinator at my hospital. Every scenario made me happy sometimes not a success because of a lot of factor from the patient, family, multidisciplinary team in the hospital. For one case to a lot of processes to prepare donor and reserve organ to another recipient. But I am proud every time in this role.
Hi Raoul,
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In my hospital caring for the brain dead patient had a multidisciplinary team. And had guideline consistency and comfortable to do.
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