Cerebral blood vessels and perfusion in the pediatric brain death: five cases studied by neuroimaging

Wang, Quan; Yu, Tao; Wu, Jie; Li, Jun; Gao, Hengmiao; Tao, Xiaojuan; Luo, Huanyu; Qian, Suyun; Peng, Yun

doi:10.1007/s00234-022-02955-4

Cited by 2 publications

(1 citation statement)

References 39 publications

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“…Wang et al published five case reports on CTA and CTP use as ancillary tests for patients 2 to 7 years old who were declared dead by neurologic criteria in China, and suggested these studies could be used as ancillary tests in other pediatric patients. 149 Relatedly, Bohatyrewicz et al announced a multicenter study to validate use of CTA, CTP, and duplex Doppler insonation of the extracranial segments of the carotid and vertebral arteries as ancillary tests in patients <12 years old. 150…”

Section: Review Of the Wbdp And Updates Since Publicationmentioning

confidence: 99%

An Update on Brain Death/Death by Neurologic Criteria since the World Brain Death Project

Lewis

2024

Semin Neurol

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The World Brain Death Project (WBDP) is a 2020 international consensus statement that provides historical background and recommendations on brain death/death by neurologic criteria (BD/DNC) determination. It addresses 13 topics including: (1) worldwide variance in BD/DNC, (2) the science of BD/DNC, (3) the concept of BD/DNC, (4) minimum clinical criteria for BD/DNC determination, (5) beyond minimum clinical BD/DNC determination, (6) pediatric and neonatal BD/DNC determination, (7) BD/DNC determination in patients on ECMO, (8) BD/DNC determination after treatment with targeted temperature management, (9) BD/DNC documentation, (10) qualification for and education on BD/DNC determination, (11) somatic support after BD/DNC for organ donation and other special circumstances, (12) religion and BD/DNC: managing requests to forego a BD/DNC evaluation or continue somatic support after BD/DNC, and (13) BD/DNC and the law. This review summarizes the WBDP content on each of these topics and highlights relevant work published from 2020 to 2023, including both the 192 citing publications and other publications on BD/DNC. Finally, it reviews questions for future research related to BD/DNC and emphasizes the need for national efforts to ensure the minimum standards for BD/DNC determination described in the WBDP are included in national BD/DNC guidelines and due consideration is given to the recommendations about social and legal aspects of BD/DNC determination.

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Section: Review Of the Wbdp And Updates Since Publicationmentioning

confidence: 99%

An Update on Brain Death/Death by Neurologic Criteria since the World Brain Death Project

Lewis

2024

Semin Neurol

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Measuring brain perfusion by CT or MR as ancillary tests for diagnosis of brain death: a systematic review and meta-analysis

Ramos,

Pinto,

Cruz e Silva

et al. 2023

BJR|Open

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Objectives To gather and synthesise evidence regarding diagnostic accuracy of perfusion imaging by CT (CTP) or MR (MRP) for brain death (BD) diagnosis. Methods A systematic review and meta-analysis was prospectively registered with PROSPERO (CRD42022336353) and conducted in accordance with the PRISMA guidelines and independently by three reviewers. PubMed/MEDLINE®, EMBASE® and Cochrane Database were searched for relevant studies. Quality Assessment of Diagnostic Accuracy Studies-2 was used to assess studies’ quality. Meta-analysis was performed using univariate random-effects models. Results Ten studies (328 patients) were included. Perfusion imaging (most commonly CTP, n = 8 studies) demonstrated a high sensitivity of 96.1% (95% CI: 89.5–98.6) for BD, consistent in subgroup analysis at 95.5% (95% CI: 86.5–98.6). Unfortunately, it was not feasible to calculate other metrics. Additionally, evidence of publication bias was identified in our findings. Conclusions The sensitivity of CTP or MRP for BD diagnosis is very high, comparable to CTA and TCD. However, considering most studies were retrospective, and lacked control groups and unambiguous criteria for perfusion imaging in BD assessment, results should be interpreted with caution. Future studies, ideally prospective, multi-centre and with control groups are of utmost importance for validation of these methods, particularly with standardized technical parameters. Advances in Knowledge Cerebral perfusion imaging using CT or MRI demonstrates high sensitivity in diagnosing BD, on par with CTA and TCD. Recommended by the World Brain Death group, this method holds promise for further investigation in this area.

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Cerebral blood vessels and perfusion in the pediatric brain death: five cases studied by neuroimaging

Cited by 2 publications

References 39 publications

An Update on Brain Death/Death by Neurologic Criteria since the World Brain Death Project

An Update on Brain Death/Death by Neurologic Criteria since the World Brain Death Project

Measuring brain perfusion by CT or MR as ancillary tests for diagnosis of brain death: a systematic review and meta-analysis

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