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Family presence during brain death evaluation: a randomized controlled trial*
Isaac Tawil1, Lawrence H Brown, David Comfort
11Department of Anesthesiology and Critical Care Medicine, Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM. 2Mount Isa Centre for Rural and Remote Health, Faculty of Medicine, Health and Molecular Sciences, James Cook University, Townsville, QLD, Australia. 3New Mexico Donor Services and University of New Mexico School of Medicine, Albuquerque, NM. 4Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM. 5Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM. 6Department of Neurosurgery, Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM. 7Department of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Family presence during brain death evaluations significantly improves understanding of brain death. This intervention is safe and feasible, showing no adverse effects on family members' psychological well-being.
Area of Science:
- Critical Care Medicine
- Neuroscience
- Family Studies
Background:
- Brain death evaluation is a critical and sensitive process.
- Family understanding of brain death significantly impacts decision-making and grief.
- Current protocols may not adequately support families during this stressful period.
Purpose of the Study:
- To determine if family presence during brain death evaluations enhances understanding.
- To assess the impact of family presence on psychological distress.
- To evaluate the feasibility and safety of a family presence intervention.
Main Methods:
- A randomized controlled trial was conducted in four ICUs.
- Family members were randomized to be present or absent during brain death evaluations.
- Validated surveys assessed understanding and psychological well-being pre- and post-intervention.
Main Results:
- Family presence significantly increased understanding of brain death (p < 0.001).
- 66% of families present achieved perfect understanding scores versus 20% absent.
- No significant difference in psychological distress (Impact of Event Scale, General Health Questionnaire) was observed between groups.
Conclusions:
- Family presence during brain death evaluations is a feasible and safe intervention.
- This intervention demonstrably improves family comprehension of brain death.
- No adverse psychological effects were noted, supporting its implementation.
