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Chapter 27 - Brain Death

from Section 3 - Specific Neurological Disorders in Emergency Medicine

Published online by Cambridge University Press:  10 January 2024

By
Rade Vukmir ,
James P. Valeriano  and
Austin Oblack
Edited by
Thomas P. Campbell  and
Kevin M. Kelly
Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
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Summary

The term “brain death” implies permanent absence of cerebral and brainstem functions. US law equates brain death with cardiopulmonary death, but specific criteria need to be met for diagnosis of brain death or death by neurologic criteria (DBNC). There are established prerequisite criteria to consider a patient for brain death that include: (1) a cause of CNS catastrophe deemed irreversible; (2) no confounding metabolic abnormality; (3) no drug intoxication or CNS depressants; (4) a normothermic state; and (5) a normotensive state. If these criteria are met, then the patient can be formally considered for DBNC.

Keywords

brain deathirreversiblenormothermiabrainstem areflexiaapnea
Type
Chapter
Information
Handbook of Emergency Neurology , pp. 392 - 394
Publisher: Cambridge University Press
Print publication year: 2023

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References

A definition of irreversible coma. Report of the Ad Hoc Committee of the Harvard Medical School to examine the definition of brain death. JAMA 1968;206:337–340.Google Scholar
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Greer, DM, Shernie, SD, Lewis, A, et al. Determination of brain death/death by neurologic criteria: the World Brain Death Project. JAMA 2020;324(11):1078–1097.CrossRefGoogle ScholarPubMed
Landmark article August 5, 1968: A definition of irreversible coma. Report of the Ad Hoc Committee of the Harvard Medical School to examine the definition of brain death. JAMA 1984;252(5):677–679.Google Scholar
Nakagawa, TA, Ashwal, S, Mathur, M, Mysore, M, Society of Critical Care Medicine-Section on Critical Care, American Society of Pediatrics- Section on Neurology and the Child Neurology Society. Guidelines for the determination of brain death in infants and children: an update of the 1987 Task Force Recommendation. Pediatrics 2011;128(3):e720–740.CrossRefGoogle Scholar
Quality Standards Subcommittee on the American Academy of Neurology. Practice parameter for determining brain death and adults (summary statement). 2015.Google Scholar
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Winkfield v. Children’s Hospital of Oakland, Temporary Restraining Order, No. RG13–707598, Super Ct Cal., December 23, 2013Google Scholar

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