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Brain death and evoked potentials in pediatric patients
M J Ruiz-López1, A Martínez de Azagra, A Serrano
1Department of Pediatrics, Hospital Infantil del Niño Jesús, Autonomous University of Madrid, Spain.
Critical Care Medicine
|March 13, 1999
Summary
Evoked potentials are valuable for diagnosing pediatric brain death, showing results similar to adults. This bedside test confirms brain death faster than electroencephalogram (EEG) flattening.
Area of Science:
- Neurology
- Pediatric Critical Care
Background:
- Brain death diagnosis in children requires precise methods.
- Evoked potentials offer objective neurological assessment.
Purpose of the Study:
- To define auditory and somatosensory evoked potential responses in pediatric brain-dead patients.
- To assess the utility of evoked potentials in confirming pediatric brain death.
Main Methods:
- Prospective study over 8 years (1988-1996) in a pediatric intensive care unit.
- Evaluated 51 pediatric patients with clinically established brain death.
- Auditory brainstem and somatosensory evoked potentials were performed.
Main Results:
- Auditory brainstem evoked potentials were compatible with brain death in 90% of patients.
- Somatosensory evoked potentials showed identifiable waves or flat records in 62.5% of tested patients.
- Evoked potential abnormalities appeared earlier than electroencephalogram (EEG) silence.
Conclusions:
- Evoked potentials are useful for confirming brain death in pediatric patients.
- The test is feasible at the bedside and yields results comparable to adults.
- Evoked potentials provide a more timely confirmation of brain death than EEG flattening.