How I do a brain death examination: the tools of the trade
2020年11月18日 · Brain death examination is hands-on (Fig. 1) and focused on brainstem function: from mesencephalon down to the dorsal medulla oblongata. These seemingly few tests are more than sufficient; other tests (e.g., IV atropine, nasal tickle, and ciliospinal reflex) add nothing. In the mesencephalon, test only one reflex circuit, the pupil response to ...
Determination of brain death for adult patients with ECMO
2015年3月16日 · ECMO has advantages on oxygenation and circulation but also it has some unfavorable effects. The most serious complication is brain death due to cerebrovascular hemorrhage. An apnea test is the most important component in confirming brain death. For patients supported by ECMO, apnea testing remains challenging.
Brainstem dysfunction in critically ill patients - Critical Care
2020年1月6日 · The brainstem conveys sensory and motor inputs between the spinal cord and the brain, and contains nuclei of the cranial nerves. It controls the sleep-wake cycle and vital functions via the ascending reticular activating system and the autonomic nuclei, respectively. Brainstem dysfunction may lead to sensory and motor deficits, cranial nerve palsies, …
Quality improvement in the determination of death by neurologic ...
2023年3月21日 · Education about brain death/death by neurologic criteria determination can be found in the Neurocritical Care Society’s Brain Death Determination Course, an online continuing medical education module endorsed by the American Academy of Neurology, which reviews components of the evaluation, prerequisites, the clinical examination, the apnea ...
Atropine test is a useful adjunct to the diagnosis of brain stem death
2000年3月6日 · The 'atropine test' was first proposed in 1975 as an adjunct to brain stem tests, and relies on the fact that there is only a contribution from the sympathetic nervous system to the heart rate in brain dead patients. The test is considered positive if the administration of 2-3 mg of atropine fails to increase the heart rate by 3%.
How I use Transcranial Doppler | Critical Care | Full Text - BioMed …
2019年12月23日 · Although the diagnosis of brain death is based on neurological examination, we use routinely TCD as an ancillary test to demonstrate the absence of cerebral blood flow (CBF) . We use one of the following TCD patterns to determine “cerebral” circulatory arrest (CCA): reverberating flow, systolic spikes, and disappearance of previously ...
Brain death and postmortem organ donation: report of a …
2018年11月16日 · Background We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation. Methods Investigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%). Results Regarding practices …
Prognostication after cardiac arrest | Critical Care | Full Text
2018年6月5日 · Hypoxic–ischaemic brain injury (HIBI) is the main cause of death in patients who are comatose after resuscitation from cardiac arrest. A poor neurological outcome—defined as death from neurological cause, persistent vegetative state, or severe neurological disability—can be predicted in these patients by assessing the severity of HIBI. The most commonly used …
How to assess prognosis after cardiac arrest and therapeutic ...
2014年1月14日 · The prognosis of patients who are admitted in a comatose state following successful resuscitation after cardiac arrest remains uncertain. Although the introduction of therapeutic hypothermia (TH) and improvements in post-resuscitation care have significantly increased the number of patients who are discharged home with minimal brain damage, short …
Experience with brain death and organ donation in a tertiary care ...
Other trauma accounted for 4 (10%), cerebro-vascular accidents for 7 (18%) and brain anoxia for 5 (20%). Thirty-one (78%) patients were Saudi nationals and 9 (22%) were non-Saudi. SCOT approached the relatives of all patients that were confirmed as brain dead and was successful in obtaining consent for organ donation from 14 (35%) of these cases.