[Limits of resuscitation. II. Cerebral death and declaring the patient dead]

For the statement of the dissociated cerebral death we perform examinations by means of which the cerebral death is confirmed and, derived from this, the death of this man is declared. In no case the time of death is determined, in which the death of the brain actually occurred. The medico-scientific criteria for the statement of the cerebral death are not normally ordered in the legal decrees of the GDR. The mode of action is regulated by law, in order to state the death without doubt and provably in connection with the legal regulations concerning the performance of the transplantations of organs. When contraindications for taking an organ are known, each obligation for diagnosing the cerebral death and the legal regulation of this diagnosis are superfluous. The cerebral death may be established purely clinically. Irresistible decrease of the body temperature and irresistible circulatory hypotension are not symptoms which by all means must be waited for. When these symptoms appear, the duration of the clinical observation may be shortened. When the diagnosis of cerebral death shall be clarified as early as possible, the angiography extended over a time of 30 min at an existing standstill of the cerebral circulation proven the diagnosis. The restriction to the angiography of the two carotids is sufficient, when clinically the syndrome of cerebral death is present. The proof of lacking bioelectric cerebral activity has no diagnostic conclusiveness. But when an isoelectric EEG is registering at the time of the first proof of unequivocal clinical signs of cerebral death and when these common findings continue to exist after 3 h, the diagnosis of cerebral death is certain. Analogically is to be proceeded when during the clinical observation the still existing cerebral electric activity cases and does not return within 3 h.