Reversible brain death after cardiopulmonary arrest and induced hypothermia*

Webb, Adam; Samuels, Owen

doi:10.1097/ccm.0b013e3182186687

Cited by 101 publications

(64 citation statements)

References 14 publications

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“…The authors of the updated American guidelines also states that rare cases of brain death claimed to being reversible have been reported [63][64][65][66]. These cases report transient return of some neurological function after a diagnosis of death using neurological criteria [67].…”

Section: Opponents Of Brain Death Conceptmentioning

confidence: 99%

Brain Death

Albar¹,

Chamsi‐Pasha²

2015

Contemporary Bioethics

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Section: Opponents Of Brain Death Conceptmentioning

confidence: 99%

Brain Death

Albar¹,

Chamsi‐Pasha²

2015

Contemporary Bioethics

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“…Among the many narrow "escape" stories that came to the attention of the media, one can think of: (i) the recovery of a 21-year-old man, who in 2008 was declared "brain-dead" thirty-six hours after his accident (Morales 2008); (ii) the recovery of a 41-year-old woman, so-called "brain-dead," who unexpectedly woke up in the operating room just as her organs were about to be removed in 2009 (O'Brien and Mulder 2013); and (iii) the recovery of a 19-year-old woman, who in 2011 also suddenly woke up while the doctors gathered around her bedside were discussing her presumed "brain death" and possible organ donation (Malm 2012). Recently, two cases of reversible "brain death" have been reported from academic tertiary hospitals (Joffe et al 2009;Webb and Samuels 2011).…”

Section: Survivors Of "Brain Death"mentioning

confidence: 99%

Brain Death and True Patient Care

Nguyen

2016

Linacre Q

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The "brain death" standard as a criterion of death is closely associated with the need for transplantable organs from heart-beating donors. Are all of these potential donors really dead, or does the documented evidence of patients destined for organ harvesting who improve, or even recover to live normal lives, call into question the premise underlying "brain death"? The aim of this paper is to re-examine the notion of "brain death," especially its clinical test-criteria, in light of a broad framework, including medical knowledge in the field of neuro-intensive care and the traditional ethics of the medical profession. I will argue that both the empirical medical evidence and the ethics of the doctor-patient relationship point to an alternative approach toward the severely comatose patient (potential braindead donor).Lay Summary: Though legally accepted and widely practiced, the "brain death" standard for the determination of death has remained a controversial issue, especially in view of the occurrence of "chronic brain death" survivors. This paper critically re-evaluates the clinical test-criteria for "brain death," taking into account what is known about the neuro-critical care of severe brain injury. The medical evidence, together with the understanding of the moral role of the physician toward the patient present before him or her, indicate that an alternative approach should be offered to the deeply comatose patient.

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“…Annals of Clinical Neurophysiology Volume 19, Number 2, July 2017 therapeutic hypothermia.There had been a case of a patient who had regained cough reflex and spontaneous respiration in the operating room for organ procurement 48 hours after rewarming from therapeutic hypothermia. 13 The guidelines as to when the EEG should be recorded after the brain injury, as well as blood pressure, oxygen saturation, body temperature, and the minimal time required after rewarming from hypothermia should be further developed. Moreover, ECI may be seen in cases where subcortical or brainstem function remains intact as EEG represents cortical activity.…”

Section: Eeg Findings Representative Of Brain Deathmentioning

confidence: 99%

Electroencephalography for the diagnosis of brain death

Lee

Kim

et al. 2017

Ann Clin Neurophysiol

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Electroencephalography (EEG) is frequently used to assist the diagnosis of brain death. However, to date there have been no guidelines in terms of EEG criteria for determining brain death in Korea, despite EEG being mandatory. The purpose of this review is to provide an update on the evidence and controversies with regarding to the utilization of EEG for determining brain death and to serve as a cornerstone for the development of future guidelines. To determine brain death, electrocerebral inactivity (ECI) should be demonstrated on EEG at a sensitivity of 2 μV/mm using double-distance electrodes spaced 10 centimeters or more apart from each other for at least 30 minutes, with intense somatosensory or audiovisual stimuli. ECI should be also verified by checking the integrity of the system. Additional monitoring is needed if extracerebral potentials cannot be eliminated. Interpreting EEG at high sensitivities, which is required for the diagnosis of brain death, can pose a diagnostic challenge. Furthermore, EEG is affected by physiologic variables and drugs. However, no consensus exists as to the minimal requirements for blood pressure, oxygen saturation, and body temperature during the EEG recording itself, the minimal time for observation after the brain injury or rewarming from hypothermia, and how to determine brain death when the findings of ECI is equivocal. Therefore, there is a strong need to establish detailed guidelines for performing EEG to determine brain death.

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Reversible brain death after cardiopulmonary arrest and induced hypothermia*

Abstract: We strongly recommend caution in the determination of brain death after cardiac arrest when induced hypothermia is used. Confirmatory testing should be considered and a minimum observation period after rewarming before brain death testing ensues should be established.

Cited by 101 publications

References 14 publications

Brain Death

Brain Death

Brain Death and True Patient Care

Electroencephalography for the diagnosis of brain death

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