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Brain Death/Death by Neurologic Criteria Determination.
Continuum (Minneapolis, Minn.)
|October 7, 2021
Summary
Determining brain death/death by neurologic criteria (BD/DNC) requires consistent standards, but variability exists. The World Brain Death Project offers guidance for global protocols, while US standards remain current.
Area of Science:
- Neurology
- Critical Care Medicine
- Medical Ethics
Background:
- Determining brain death/death by neurologic criteria (BD/DNC) is crucial for consistent medical practice.
- Variability in BD/DNC prerequisites, clinical evaluation, and ancillary testing exists globally.
- Challenging clinical scenarios, such as ECMO or therapeutic hypothermia, complicate BD/DNC determination.
Purpose of the Study:
- To describe the prerequisites for BD/DNC determination.
- To outline clinical evaluation methods, including apnea testing.
- To discuss the use of ancillary testing and challenges in BD/DNC assessment.
Main Methods:
- Review of current literature and guidelines on BD/DNC determination.
- Analysis of variability in BD/DNC protocols across different regions.
- Consideration of the World Brain Death Project's consensus statement.
Main Results:
- Significant variability exists in BD/DNC determination practices worldwide.
- The World Brain Death Project has developed an international consensus statement.
- Existing US standards from 2010 (adults) and 2011 (pediatrics) remain the accepted medical standards.
Conclusions:
- The World Brain Death Project statement aims to guide protocol revision globally.
- Local laws, culture, and resources should inform BD/DNC protocol development.
- Current US standards for BD/DNC determination remain in effect pending updated guidelines.
