Diagnosis of Brain Death by Common Carotid Artery Velocity Waveform Analysis

Kreutzer, Erik W.; Rutherford, Robert B.; Lehman, Ralph A. W.

doi:10.1001/archneur.1982.00510150006002

Cited by 22 publications

(2 citation statements)

References 7 publications

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“…Such flow is presumed to support brain tissue; hence, in its presence, the diagnosis of brain death is negated. This technique appears to require a high level of technical expertise for its interpretation, and occasional false positive tests have been noted [69,70].…”

Section: Tests Of Blood Flow (Direct or Indirect)mentioning

confidence: 99%

Analytic Reviews : The Diagnosis of Brain Death in the Adult Patient

Powner

1987

J Intensive Care Med

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The biological tenet upon which brain death is founded is absolute. The brain's inability to undergo cellular division ensures that once individual neurons die they cannot be replaced. Extrapolating this to the total brain, once the entire brain is dead no recovery can occur, and the patient's family can be guaranteed of that fact. The clinician, therefore, is faced primarily with a diagnostic challenge in determining that brain death is indeed present. The components, procedures, and limitations of that diagnostic process in the adult patient are the subjects of this discussion. Natural HistoryA controlled trial incorporating a standardized treatment protocol and addressing the issue of cardiovascular survival after brairi death has never been published. Most earlier literature, however, has taught that spontaneous cardiac arrest usually occurs within 24 to 72 hours and always within two weeks [1-4] after brain death. With current cardiorespiratory support techniques, however, prolonged somatic survival is more common [5], although spontaneous cardiac arrests do occur. Early cardiac failure supports the urgency felt by many physicians to proceed quickly with the diagnosis of brain death, especially when organ removal for donation is a factor. _ Brain death, or coma depasse, has generally been defined as the irreversible cessation of the function of all parts of the brain above the foramen magnum. Cerebral death identifies the permanent loss of function of both cerebral hemispheres and is synonymous with neocortical death. Unfortunately, the terms brain death and cerebral death have.been used interchangeably, but they are not synonymous. Brainstem death has been identified primarily in the British literature as a vital component of brain death and also as a recognizable separate entity that may exist without cerebral death [6,7]. The philosophical and moral positions supporting termination of life support and initiation of organ removal when only cerebral or brainstem function has ceased, as proposed by some [8], are not discussed here. This article is based on the generally accepted medical, legal, and sociological definition of brain death as that requiring loss of all components of the brain. The interested reader is referred tQ the several review articles available regarding the ethical and legal issues surrounding this topic [9][10][11].

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Section: Tests Of Blood Flow (Direct or Indirect)mentioning

confidence: 99%

Analytic Reviews : The Diagnosis of Brain Death in the Adult Patient

Powner

1987

J Intensive Care Med

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“…• The carotid velocity index (CVI) (Kreutzer et al, 1982) is defined as CVI = (peak amplitude -end diastolic amplitude)/peak amplitude • Laplace transform coefficients are derived using the Laplace transform methods (Skidmore and Woodcock, 1980;Johnston et al, 1984). The heart is assumed to produce a unit impulse input.…”

Section: Use Of Blood Velocity Waveforms and Indicesmentioning

confidence: 99%