1. Intensive care practices in brain death diagnosis and organ donation.
- Author
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Escudero, D., Valentín, M. O., Escalante, J. L., Sanmartín, A., Perez‐Basterrechea, M., Gea, J., Martín, M., Velasco, J., Pont, T., Masnou, N., Calle, B., Marcelo, B., Lebrón, M., Pérez, J. M., Burgos, M., Gimeno, R., Kot, P., Yus, S., Sancho, I., and Zabalegui, A.
- Subjects
CRITICAL care medicine ,BRAIN death ,ORGAN donation ,INTENSIVE care units ,HEMORRHAGE ,DIAGNOSIS ,COMPARATIVE studies ,LENGTH of stay in hospitals ,RESEARCH methodology ,MEDICAL cooperation ,NEUROSURGERY ,ORGAN donors ,RESEARCH ,PROFESSIONAL practice ,EVALUATION research ,GLASGOW Coma Scale ,TRAUMA severity indices - Abstract
We conducted a multicentre study of 1844 patients from 42 Spanish intensive care units, and analysed the clinical characteristics of brain death, the use of ancillary testing, and the clinical decisions taken after the diagnosis of brain death. The main cause of brain death was intracerebral haemorrhage (769/1844, 42%), followed by traumatic brain injury (343/1844, 19%) and subarachnoid haemorrhage (257/1844, 14%). The diagnosis of brain death was made rapidly (50% in the first 24 h). Of those patients who went on to die, the Glasgow Coma Scale on admission was ≤ 8/15 in 1146/1261 (91%) of patients with intracerebral haemorrhage, traumatic brain injury or anoxic encephalopathy; the Hunt and Hess Scale was 4-5 in 207/251 (83%) of patients following subarachnoid haemorrhage; and the National Institutes of Health Stroke Scale was ≥ 15 in 114/129 (89%) of patients with strokes. Brain death was diagnosed exclusively by clinical examination in 92/1844 (5%) of cases. Electroencephalography was the most frequently used ancillary test (1303/1752, 70.7%), followed by transcranial Doppler (652/1752, 37%). Organ donation took place in 70% of patients (1291/1844), with medical unsuitability (267/553, 48%) and family refusal (244/553, 13%) the main reasons for loss of potential donors. All life-sustaining measures were withdrawn in 413/553 of non-donors (75%). [ABSTRACT FROM AUTHOR]
- Published
- 2015
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