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Publication year
2010Source
Intensive Care Medicine, 36, 9, (2010), pp. 1488-94ISSN
Annotation
01 september 2010
Publication type
Article / Letter to editor
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Organization
Nephrology
Neurology
Journal title
Intensive Care Medicine
Volume
vol. 36
Issue
iss. 9
Page start
p. 1488
Page end
p. 94
Subject
N4i 4: Auto-immunity, transplantation and immunotherapyAbstract
PURPOSE: There is, in European countries that conduct medical chart review of intensive care unit (ICU) deaths, no consensus on uniform criteria for defining a potential organ donor. Although the term is increasingly being used in recent literature, it is seldom defined in detail. We searched for criteria for determination of imminent brain death, which can be seen as a precursor for organ donation. METHODS: We organized meetings with representatives from the field of clinical neurology, neurotraumatology, intensive care medicine, transplantation medicine, clinical intensive care ethics, and organ procurement management. During these meetings, all possible criteria were discussed to identify a patient with a reasonable probability to become brain dead (imminent brain death). We focused on the practical usefulness of two validated coma scales (Glasgow Coma Scale and the FOUR Score), brain stem reflexes and respiration to define imminent brain death. Further we discussed criteria to determine irreversibility and futility in acute neurological conditions. RESULTS: A patient who fulfills the definition of imminent brain death is a mechanically ventilated deeply comatose patient, admitted to an ICU, with irreversible catastrophic brain damage of known origin. A condition of imminent brain death requires either a Glasgow Coma Score of 3 and the progressive absence of at least three out of six brain stem reflexes or a FOUR score of E(0)M(0)B(0)R(0). CONCLUSION: The definition of imminent brain death can be used as a point of departure for potential heart-beating organ donor recognition on the intensive care unit or retrospective medical chart analysis.
This item appears in the following Collection(s)
- Academic publications [246515]
- Electronic publications [134102]
- Faculty of Medical Sciences [93308]
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