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Semin Neurol 2016; 36(06): 625-630
DOI: 10.1055/s-0036-1592317
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Modern Approach to Brain Death

Panayiotis N. Varelas
1   Division of Neurosciences Critical Care Services, Department of Neuro-Intensive Care Unit, Detroit, Michigan
2   Department of Neurology, Wayne State University, Detroit, Michigan
,
Ariane Lewis
3   Division of Neurocritical Care, Department of Neurology and Neurosurgery, NYU Langone Medical Center, New York, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
01 December 2016 (online)

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Abstract

People die either when their heart and respiration stop or when their brain irreversibly stops functioning. This latter mode of death by neurologic criteria (also called brain death) emerged after the development of ventilators and intensive care units in the late 1950s and 1960s. Brain death is universally accepted as a modern entity, but the complex process for declaring a patient brain dead is not uniformly followed across country and state lines or even hospital policies, creating unacceptable variability and risks for falsely pronouncing a patient dead. If, however, the declaring physician has expertise and diligently follows the steps that have been published in guidelines, this risk is mitigated. In this article, the authors describe the steps for brain death declaration, discuss how to avoid pitfalls, and examine the modern controversies regarding this medical reality.

Keywords

brain death - brainstem death - apnea test - ancillary tests - prerequisites - challenges - organ donation
 

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