Brain-death criteria currently used by pediatric intensivists

Clin Pediatr (Phila). 1992 Aug;31(8):457-60. doi: 10.1177/000992289203100802.

Abstract

A survey was done to identify how pediatric intensivists determine brain death in children. Forty-nine pediatric intensive-care units (PICUs) were surveyed. The questionnaire explored the following areas: 1) clinical and confirmatory studies performed, 2) types of physicians involved, and 3) reevaluation intervals. Thirty-four centers responded to the questionnaire. Sixty-nine percent were children's hospitals, and 94% were university affiliates. The mean number of PICU beds was 17, with a mean admission rate of 890 patients per year, and the mean mortality rate for these units was 6%. There was general agreement on the sufficiency of clinical examination to determine cortical and brain-stem function. All the pediatric intensivists noted that a positive apnea test, absent cephalic reflexes, fixed and dilated pupils, and no motor response to pain were reliable signs of brain death. Radionuclide cerebral-flow scan and EEG were the confirmatory tests routinely used. Most physicians (77%) felt a second clinical examination was required within 12 to 24 hours. The opinion of more than one physician, one of whom was a neurospecialist, was required in 80% of the surveyed institutions.

MeSH terms

  • Blood Flow Velocity
  • Brain Death / diagnosis*
  • Brain Death / diagnostic imaging
  • Canada
  • Causality
  • Cerebrovascular Circulation
  • Child
  • Clinical Protocols / standards
  • Critical Care / methods
  • Critical Care / standards*
  • Electroencephalography
  • Hospital Bed Capacity
  • Hospital Mortality
  • Hospitals, Pediatric
  • Hospitals, University
  • Humans
  • Intensive Care Units, Pediatric / statistics & numerical data
  • Neurologic Examination
  • Patient Admission / statistics & numerical data
  • Pediatrics / methods
  • Pediatrics / standards*
  • Practice Patterns, Physicians' / standards*
  • Radionuclide Imaging
  • Referral and Consultation
  • Surveys and Questionnaires
  • United States