Brain Death in Children The Philadelphia Experience
Despite statements that the infant’s or child’s brain is more resistant to anoxia than is the adult brain, there is no evidence that this is a practical benefit to the child other than by extending the tolerance for a few minutes. Recent reports have suggested that the criteria for brain death in children should be different from those in adults (President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, 1982; Task Force for the Determination of Brain Death in Children, 1987). If the premature baby is excluded, there is no reason for the criteria to be different from those of the President’s Commission. If the criteria are followed, the clinical diagnosis of brain death can be made safely in infants and children. Indeed, it is the author’s experience that the clinical examination may define residual brain functions when, in fact, none exist, thereby erring on the side of suggesting that the possibility of survival may be present, when indeed it is not. It is not uncommon in children during their first year of life to find quite complex arm and leg movements, such as a bicycling type of activity, in the absence of intracranial blood flow.
KeywordsCerebral Blood Flow Organ Donation Brain Death Ancillary Test Organ Retrieval
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