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Minimum Criteria for Brain Death Determination: Consensus Promotion and Chinese Practice
Yingying Su1,2, Yan Zhang3,4, Weibi Chen3,4
1Neurointensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. suyingying@xwh.ccmu.edu.cn.
Neurocritical Care
|May 10, 2022
Summary
The three-step quality control plan (QCP) effectively improved brain death determination (BDD) accuracy in China. Analysis revealed common errors in apnea testing, guiding future quality control improvements for BDD.
Area of Science:
- Neurology
- Medical Ethics
- Quality Improvement
Background:
- Brain death (BD) determination guidelines were established in China in 2013 by the Brain Injury Evaluation Quality Control Center (BQCC).
- A three-step quality control plan (QCP) was implemented to ensure safety and consistency in clinical brain death determination (BDD).
Purpose of the Study:
- To retrospectively review the three-step QCP for brain death determination (BDD).
- To identify implementation challenges and provide recommendations for future quality control in BDD.
Main Methods:
- Data were analyzed from the BQCC database, including physician training results and hospital BDD case records.
- Physicians' performance in BDD training and accreditation submissions were evaluated.
Main Results:
- Physician BDD paper tests showed highest error rates in limb movement discrimination (26.29%), correlated with age.
- Apnea testing presented the most significant issues in both physician training (22.75%) and case record review (41.73%).
- Ancillary testing also showed notable problems (16.17%) in the second step of the QCP.
Conclusions:
- The three-step QCP demonstrates significant utility in enhancing the accuracy and appropriateness of brain death determination (BDD).
- This study provides crucial evidence for the ongoing advancement of quality control measures for BDD.
