Evaluation of Patients with Diagnosis of Brain Death
PDF
Cite
Share
Request
Research Article
P: 156-159
December 2019

Evaluation of Patients with Diagnosis of Brain Death

J Pediatr Emerg Intensive Care Med 2019;6(3):156-159
1. Fırat Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Elazığ, Türkiye
2. Fırat Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı, Elazığ, Türkiye
No information available.
No information available
Received Date: 17.07.2018
Accepted Date: 09.12.2018
Publish Date: 21.10.2019
PDF
Cite
Share
Request

ABSTRACT

Conclusion:

When clinical evaluation is not sufficient in the diagnosis of BD, examination findings should be supported by laboratory tests. In the process for determining BD, a very rigorous general care and monitoring should be done. We believe that laboratory parameters should be closely monitored in cases diagnosed with BD.

Results:

Twelve patients were diagnosed with BD. The mean age was 6.18±1.3 years. The most frequent diagnosis was post-traumatic BD (73%) in our PICU. Apnea testing was performed in all cases and radiological imaging methods were used in 36% (n=4) to support the diagnosis. The donation rate was 27% (n=3). Nine patients (82%) received vasopressor for hypotension, 5 (46%) received insulin for hyperglycemia, and 3 (27%) had desmopressin therapy for diabetes insipidus. Tests were performed in 82% of patients (n=9) for the diagnosis of BD in the first week of hospitalization. When the laboratory data and infusion status were compared on the day of hospitalization and on the day of diagnosis, similar results were found except for potassium and platelet count.

Methods:

The patients with a diagnosis of BD between January 2016 and October 2017 were analyzed retrospectively. Demographic characteristics, diagnoses, BD detection time, additional tests, family’s consent to organ donation and donation rate, hospitalization day and routine laboratory data on the diagnosis day and insulin-desmopressin-vasopressor/inotropic infusions were recorded.

Introduction:

The aim of this study was to retrospectively evaluate the brain death (BD) cases in our pediatric intensive care unit (PICU) within a period of two years.

Keywords:
Brain death, pediatric intensive care unit, donor, organ donation

References

1
Halevy, A. and B. Brody, Brain death: reconciling definations, criteria, and tests. Ann Intern Med. 1993;119:519-25.
2
Todres D. Brain Death. In: Slonim AD, Pollack MM (eds). Pediatric Critical Care Medicine. Philadelphia: Lippincott Williams &Willkins; 2006:790-5.
3
Öztürk Yalındağ N, İnceköy F, Birtan D, Cinel İ. Exploring Brain Death at a Tertiary Pediatric Intensive Care Unit in Turkey; Incidence, Etiology and Organ Donation. Pediatr Emerg Intensive Care Med. 2016;3:11-4.
4
Kıraklı C, Uçar ZZ, Anıl AB, Özbek İ. The effect of shortening confirmed brain death diagnosis time on organ donation rates in the intensive care unit. Yoğun Bakım Derg. 2011;1:8-11.
5
Organ ve doku alınması, saklanması, aşılanması ve nakli hakkında kanun. Kanun Numarası 6514 Resmi Gazete 18.01.2014.
6
Jansen NE, van Leiden HA, Haase-Kromwijk BJ, Hoitsma AJ. Organ donation performance in the Netherlands 2005-08; medical record review in 64 hospitals. Nephrol Dial Transplant. 2010;25:1992-7.
7
Karasu D, Yılmaz C, Karaduman İ, Çınar YS, Büyükkoyuncu Peker N. Beyin ölümü olguların retrospektif incelenmesi. Yoğun Bakım Dergisi. 2015;6:23-6.
8
Battal M, Horoz A, Karatepe O, Çitgez B. Beyin ölümü tespitinde araştırma hastanesi deneyimi. Şişli Etfal Hastanesi Bülteni. 2013;47:59-62.
9
Golchet G, Carr J, Harris MG. Why don’t we have enough cornea donors? A literature review and survey. Optometry. 2000;71:318-28.
10
Wood KE, Becker BN, McCartney JG, D’Alessandro AM, Coursin DB. Care of the potential organ donor. N Engl J Med. 2004;351:2730-9.
11
Compagnon P, Wang H, Lindell SL, Ametani MS, Mangino MJ, et al. Brain death does not affect hepatic allograft function and survival after orthotopic transplantation in a canine model. Transplantation. 2002;73:1218-27.
12
Powers BM, van Heereden PV. The physiological changes associated with brain death: Current concepts and implications for treatment of the brain dead organ donor. Anesth Intensive Care. 1995;23:26-36.
13
Fackler JC, Troncoso JC, Gioia FR. Age-specific characteristics of brain death in children. Am J Dis Child. 1988;142:999-1003.
14
Nair-Collins M, Northrup J, Olcese J. Hypothalamic- PituitaryFunction in Brain Death: A Review. J Intensive Care Med. 2016;31:41-50.