Death and Donation in Critical Care: The Diagnosis of Brainstem Death
- 2k Downloads
In the United Kingdom, brainstem death testing can, in the majority of circumstances, be performed at the bedside.
Brainstem death testing cannot be contemplated unless drug intoxication, hypothermia, and metabolic and electrolyte disturbances have been excluded.
Four vessel cerebral angiography may be helpful in cases of brainstem death testing, where drug intoxication or metabolic disturbance is confusing the clinical picture.
Management of the potential heart-beating organ donor requires high- quality critical care, support of the cardiovascular, respiratory, and renal systems, and early commencement of hormonal therapy.
In cases of potential controlled donation after cardiac death, analgesia and anxiolysis must not be given simply to accelerate asystole, and thereby facilitate donation.
KeywordsDrug Intoxication Reflex Test Neurogenic Pulmonary Edema Apnea Test Comatose State
- A code of practice for the diagnosis and confirmation of death. Academy of Medical Royal Colleges (2008) http://www.aomrc.org.uk/
- Conference of Medical Royal Colleges and their Faculties in the UK (1995) The criteria for the diagnosis of brainstem death. J R Coll Phys (Lond) 29: 381–382 Google Scholar
- http://www.ics.ac.uk/icmprof/downloads/Organ%20&%20Tissue%20Donation.pdf, Accessed 29 April 2008
- Mollaret P, Goulon M (1959) Le coma depassé. Rev Neurol (Paris) 101:3–15Google Scholar
- Pallis C, Harley DH (1996) ABC of brainstem death. BMJ publishing group, LondonGoogle Scholar