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22. International guideline development for the determination of death

Author

Shemie, S, Hornby, L, Baker, A, Teitelbaum, J, Torrance, S, Young, K, Capron, A, Bernat, J, Noel, L, Abdelhak, T, Beloucif, S, Salah Ben Ammar, M, Bernat, JL, Black, P, Bleck, T, Bo hatyrewicz, R, Capron, AM, Dobb, G, Jasim, W, Jimenez, E, Kirste, G, Kiat Kwek, T, Manara, A, Shemie, SD, Sinkin, M, Sprung, CL, Sung, G, Tallon, J, Teitielbaum, J, Wijdicks, E, Young, GB, CITERIO, GIUSEPPE, Shemie, S, Hornby, L, Baker, A, Teitelbaum, J, Torrance, S, Young, K, Capron, A, Bernat, J, Noel, L, Abdelhak, T, Beloucif, S, Salah Ben Ammar, M, Black, P, Bleck, T, Bo hatyrewicz, R, Citerio, G, Dobb, G, Jasim, W, Jimenez, E, Kirste, G, Kiat Kwek, T, Manara, A, Sinkin, M, Sprung, C, Sung, G, Tallon, J, Teitielbaum, J, Wijdicks, E, and Young, G

Subjects
Autoresuscitation, Internationality, Conference Reports and Expert Panel, Circulatory death, education, Critical Care and Intensive Care Medicine, Organ donation, Humans, Medicine, Guideline development, Brain injury, Cardiac death, health care economics and organizations, Cardiopulmonary resuscitation, Brain death, business.industry, medicine.disease, humanities, Death, Practice Guidelines as Topic, Death determination, Professional association, Engineering ethics, Medical emergency, business
Abstract

Introduction and Methods: This report summarizes the results of the first phase in the development of international guidelines for death determination, focusing on the biology of death and the dying process, developed by an invitational forum of international content experts and representatives of a number of professional societies. Results and Conclusions: Precise terminology was developed in order to improve clarity in death discussion and debate. Critical events in the physiological sequences leading to cessation of neurological and/or circulatory function were constructed. It was agreed that death determination is primarily clinical and recommendations for preconditions, confounding factors, minimum clinical standards and additional testing were made. A single operational definition of human death was developed: 'the permanent loss of capacity for consciousness and all brainstem functions, as a consequence of permanent cessation of circulation or catastrophic brain injury'. In order to complete the project, in the next phase, a broader group of international stakeholders will develop clinical practice guidelines, based on comprehensive reviews and grading of the existing evidence. © 2014 Springer-Verlag Berlin Heidelberg and ESICM.

Published
2014

24. Organ donation in adults: a critical care perspective

Author

Citerio, G, Cypel, M, Dobb, G, Dominguez Gil, B, Frontera, J, Greer, D, Manara, A, Shemie, S, Smith, M, Valenza, F, Wijdicks, E, CITERIO, GIUSEPPE, Wijdicks, E., Citerio, G, Cypel, M, Dobb, G, Dominguez Gil, B, Frontera, J, Greer, D, Manara, A, Shemie, S, Smith, M, Valenza, F, Wijdicks, E, CITERIO, GIUSEPPE, and Wijdicks, E.

Abstract

Purpose: The shortage of organs for transplantation is an important medical and societal problem because transplantation is often the best therapeutic option for end-stage organ failure. Methods: We review the potential deceased organ donation pathways in adult ICU practice, i.e. donation after brain death (DBD) and controlled donation after circulatory death (cDCD), which follows the planned withdrawal of life-sustaining treatments (WLST) and subsequent confirmation of death using cardiorespiratory criteria. Results: Strategies in the ICU to increase the number of organs available for transplantation are discussed. These include timely identification of the potential organ donor, optimization of the brain-dead donor by aggressive management of the physiological consequence of brain death, implementation of cDCD protocols, and the potential for ex vivo perfusion techniques. Conclusions: Organ donation should be offered as a routine component of the end-of-life care plan of every patient dying in the ICU where appropriate, and intensivists are the key professional in this process.

Published
2016

26. Posters

Author

Gorodetsky, V. M., Shulutko, E. M., Nishiyama, T., Hanaoka, K., Kingsley, J. M., Tcijink, J. A. W., Haasnoot, K., Ekkelkamp, S., Mahicu, H. F., Vos, A., Anglès, R., Masclans, J. R., Bermejo, B., Ferrer, R., Peracaula, R., de Latorre, F. J., Biswas, I. H., Wijdicks, E. F. M., Plevak, D. J., Le Roy, I., Spapen, H., Jochmans, K., Vleminckx, W., Diltoer, M., Huyghens, L., Pierard, D., De Mey, J., Delvaux, G., van Meeteren, M. C., Braams, R., Hulstaert, P. F., Bosaue, M. D., Vila, J., Palomar, M., Bastin, R., Moraine, J. -J., Bardocsky, G., Kahn, R. J., and Mélot, C.

Published
1996
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27. MP07: Diagnosis of elevated intracranial pressure in critically ill adults – a systematic review and meta-analysis

Author

Fernando, S., primary, Tran, A., additional, Cheng, W., additional, Rochwerg, B., additional, Taljaard, M., additional, Kyeremanteng, K., additional, English, S., additional, Sekhon, M., additional, Griesdale, D., additional, Dowlatshahi, D., additional, Czosnyka, M., additional, McCredie, V., additional, Wijdicks, E., additional, Almenawer, S., additional, Inaba, K., additional, Rajajee, V., additional, and Perry, J., additional

Published
2019
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29. Long‐term mortality, disability and stroke recurrence in patients with basilar artery occlusion.

Author

Hawkes, M. A., Blaginykh, E., Ruff, M. W., Burrus, T., Wijdicks, E. F. M., and Rabinstein, A. A.

Subjects
BASILAR artery, STROKE patients, PATIENTS, DISABILITIES, LOG-rank test, MORTALITY
Abstract

Background and purpose: The long‐term outcomes and stroke recurrence after basilar artery occlusion (BAO) are largely unknown. We aimed to assess these variables in a comparatively large series of consecutive patients. Methods: Adults with acute BAO were retrospectively identified from 1976 to 2011. Post‐discharge records were reviewed to assess for stroke recurrences, mortality and disability. Exploratory analysis of survival was carried out using Kaplan–Meier and log‐rank tests. Factors associated with survival time were determined using Cox models. Results: A total of 86 patients (34% female, median age 72 [interquartile range (IQR), 60–79] years) with a median National Institutes of Health Stroke Scale score of 11 (IQR, 6–27) were included. Twenty‐nine patients (34%) died during the initial hospitalization. Median modified Rankin Scale (mRS) score at discharge among survivors was 4 (IQR, 2.5–5.5). At 1 and 5 years, 70% of survivors ad a mRS ≤3. Seventeen patients had recurrent strokes during the hospitalization and 12 patients had 19 recurrent strokes after discharge. The median survival time was 52 days (IQR, 6–1846). Older age per decade on admission [adjusted hazard ratios (aHR), 1.32; 95% confidence interval (CI), 1.05–1.66, P = 0.02] and a higher mRS at discharge (aHR, 4.48; 95% CI, 2.72–7.39, P < 0.0001) were associated with mortality. Patients who were not treated with any reperfusion therapy had a trend towards reduced mortality (aHR, 0.39; 95% CI, 0.14–1.08, P = 0.07). Conclusions: Survivors from BAO had severe short‐term functional disability. Most deaths and stroke recurrences occurred within the first year following the initial event. The risk of death was higher in older and more disabled survivors. However, favorable long‐term recovery was possible. [ABSTRACT FROM AUTHOR]

Published
2020
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32. Brain MRI findings in infective endocarditis

Author

Chakraborty, T., primary, Scharf, E., additional, Rabinstein, A., additional, DeSimone, D., additional, El Rafei, A., additional, Brinjikji, W., additional, Baddour, L., additional, Wijdicks, E., additional, Wilson, W., additional, Steckelberg, J., additional, and Fugate, J., additional

Published
2017
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40. MRI spot sign

Author

Cutsforth-Gregory, J. K., primary, Black, D. F., additional, Hoffman, E. M., additional, Datar, S. V., additional, and Wijdicks, E. F., additional

Published
2014
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