A review of current controversies in determining death by neurologic criteria in children.

Szczegóły
Abstrakt

Tytuł:: A review of current controversies in determining death by neurologic criteria in children.
Autorzy:: Virupakshaiah A; Department of Neurology.
Ichord R; Department of Neurology.; Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Philadelphia, Pennsylvania, USA.
Topjian AA; Department of Anesthesiology and Critical Care Medicine.; Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Philadelphia, Pennsylvania, USA.
Kirschen MP; Department of Neurology.; Department of Anesthesiology and Critical Care Medicine.; Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Philadelphia, Pennsylvania, USA.
Źródło:: Current opinion in pediatrics [Curr Opin Pediatr] 2020 Dec; Vol. 32 (6), pp. 759-764.
Typ publikacji:: Journal Article; Review
Język:: English
Imprint Name(s):: Publication: Philadelphia, PA : Lippincott Williams and Wilkins
Original Publication: Philadelphia, PA : Current Science, c1989-
MeSH Terms:: Brain Death*/diagnosis
Diagnostic Techniques, Neurological*
Child ; Humans ; Intensive Care Units, Pediatric
References:: Uniform Determination Of Death Act Drafted by the National Conference of Commissioners on Uniform State. 1980; 1–3.
Report Of Special Task Force. Guidelines For The Determination Of Brain Death In Children. Pediatrics 1987; 80:298–300.
Nakagawa TA, Ashwal S, Mathur M, et al. Clinical report - Guidelines for the determination of brain death in infants and children: an update of the 1987 task force recommendations. Pediatrics 2011; 128:e720–740.
Pollack MM, Holubkov R, Funai T, et al. Simultaneous prediction of new morbidity, mortality, and survival without new morbidity from pediatric intensive care: a new paradigm for outcomes assessment. Crit Care Med 2015; 43:1699–1709.
Kirschen MP, Francoeur C, Murphy M, et al. Epidemiology of brain death in pediatric intensive care units in the United States. JAMA Pediatr 2019; 19104:469–476.
Agra Tuñas MC, Pilar Orive FJ, Rodríguez Merino E, et al. Modes of dying of children in Intensive Care Units in Spain: MOMUCIP study. An Pediatría 2019; 91:228–236.
Busl KM, Lewis A, Varelas PN. Apnea testing for the determination of brain death: a systematic scoping review. Neurocritical care. Totowa, NJ: Humana Press; 2020.
Greer DM, Shemie SD, Lewis A, et al. Determination of brain death/death by neurologic criteria: the World Brain Death Project. JAMA 2020; [Epub ahead of print].
Puccetti DF, Morrison W, Francoeur C, et al. Apnea testing using continuous positive airway pressure when determining death by neurologic criteria in children: retrospective analysis of potential adverse events. Pediatr Crit Care Med 2020. 1–2.
Sochet AA, Bingham L, Sreedhar S, et al. Transcutaneous carbon dioxide monitoring during apnea testing for determination of neurologic death in children: a retrospective case series. Pediatr Crit Care Med 2020; 21:437–442.
Jarrah RJ, Ajizian SJ, Agarwal S, et al. Developing a standard method for apnea testing in the determination of brain death for patients on venoarterial extracorporeal membrane oxygenation: a pediatric case series. Pediatr Crit Care Med 2014; 15:e38–43.
Harrar DB, Kukreti V, Dean NP, et al. Clinical determination of brain death in children supported by extracorporeal membrane oxygenation. Neurocrit Care 2019; 31:304–311.
Migdady I, Stephens RS, Price C, et al. The use of apnea test and brain death determination in patients on extracorporeal membrane oxygenation: a systematic review. J Thorac Cardiovasc Surg 2020; [Epub ahead of print].
Ihle JF, Burrell AJC, Philpot SJ, et al. A protocol that mandates postoxygenator and arterial blood gases to confirm brain death on venoarterial extracorporeal membrane oxygenation. ASAIO J 2020; 66:e23–e28.
Beam WB, Scott PD, Wijdicks EFM. The physiology of the apnea test for brain death determination in ECMO: arguments for blending carbon dioxide. Neurocrit Care 2019; 31:567–572.
Henderson N, McDonald M. Ancillary studies in evaluating pediatric brain death. J Pediatr Intensive Care 2017; 06:234–239.
Kirschen MP, Puccetti DF, Morrison W. Incidence and indications for ancillary testing in the determination of death by neurological criteria in children. Pediatr Neurol 2020; 106:68–69.
Latorre JGS, Schmidt EB, Greer DM. Another pitfall in brain death diagnosis: return of cerebral function after determination of brain death by both clinical and radionuclide cerebral perfusion imaging. Vol. 32. Neurocritical care. 2020; Totowa, NJ: Humana Press, p. 899-905.
Dalle Ave AL, Bernat JL. Inconsistencies between the criterion and tests for brain death. J Intensive Care Med 2020; 35:772–780.
Hernández-Hernández MÁ, Marco de Lucas E, Muñoz-Esteban C, et al. The observation period after clinical brain death diagnosis according to ancillary tests: differences between supratentorial and infratentorial brain injury. J Neurol 2019; 266:1859–1868.
Lewis A, Greer D. POINT: Should informed consent be required for apnea testing in patients with suspected brain death? No Chest 2017; 152:700–702.
Truog RD, Tasker RC. COUNTERPOINT: should informed consent be required for apnea testing in patients with suspected brain death? Yes Chest 2017; 152:702–704.
Berkowitz I, Garrett JR. Legal and ethical considerations for requiring consent for apnea testing in brain death determination. Am J Bioeth 2020; 20:4–16.
Joffe AR. The apnea test: requiring consent for a test that is a self-fulfilling prophecy, not fit for purpose, and always confounded? Am J Bioeth 2020; 20:42–44.
Lazaridis C. Accommodating apnea testing not death determination refusal. Am J Bioeth 2020; 20:47–49.
Antommaria AHM, Sveen W, Stalets EL. Informed consent should not be required for apnea testing and arguing it should misses the point. Am J Bioeth 2020; 20:25–27.
Bertino J, Potter J. Requiring consent for brain-death testing: a perilous proposal. Am J Bioeth 2020; 20:28–30.
Lewis A, Greer D. Medicolegal complications of apnoea testing for determination of brain death. J Bioeth Inq 2018; 15:417–428.
Bhagat D, Lewis A. The case against solicitation of consent for apnea testing. Am J Bioeth 2020; 20:20–22.
Lewis A, Adams N, Chopra A, Kirschen MP. Organ support after death by neurologic criteria in pediatric patients. Crit Care Med 2017; 45:e916–e924.
Lewis A, Bonnie RJ, Pope T, et al. Determination of death by neurologic criteria in the united states: the case for revising the uniform determination of death act. J Law, Med Ethics 2019; 47: (4_suppl): 9–24.
Pope T. Brain death and the law: hard cases and legal challenges. Hastings Cent Rep 2018; 48 (S4):S46–S48.
Johnson DO, Westphal CG. Addressing religious or cultural opposition to brain death diagnosis. J Hosp Palliat Nurs 2018; 20:252–259.
Lewis A. A survey of multidenominational rabbis on death by neurologic criteria. Neurocrit Care 2019; 31:411–418.
Rady MY. Objections to brain death determination: religion and neuroscience. Neurocrit Care 2019; 31:446–448.
Mathur M, Nakagawa TA. Be still my beating heart-using reduction in heart rate variability as a predictor of brain death. Pediatr Crit Care Med 2019; 20:84–85.
Lee BM, Trowbridge A, McEvoy M, et al. Can a parent refuse the brain death examination? Pediatrics 2020; 145:.
Bibler T, Galbraith K, Brothers K. Ethics and brain death in pediatrics: recent controversy and practical suggestions. J Pediatr Intensive Care 2017; 06:240–244.
Russell JA, Epstein LG, Greer DM, et al. Brain death, the determination of brain death, and member guidance for brain death accommodation requests. Neurology 2019; 92:228–232.
Lewis A, Bernat JL, Blosser S, et al. An interdisciplinary response to contemporary concerns about brain death determination. Neurology 2018; 90:423–426.
Nguyen D. Does the uniform determination of death act need to be revised? Linacre Q 2020; 87:317–333.
Biel S, Durrant J. Controversies in brain death declaration: legal and ethical implications in the ICU. Curr Treat Options Neurol 2020; 22:.
Truog RD, Paquette ET, Tasker RC. Understanding brain death. JAMA 2020; 323:2139–2140.
OPENPediatrics | The world's best practices, shared worldwide. https://www.openpediatrics.org/. [Accessed 2 August 2020].
Brain Death Determination Course - Neurocritical Care Society https://www.neurocriticalcare.org/education/braindeath. [Accessed 4 August 2020].
Correia CER, De Oliveira Godeiro C. Development of a digital tool to assist the training of health professionals in the determination of brain death. Stud Health Technol Inform 2019; 264:1174–1178.
Joffe AR, deCaen A, Garros D. Misinterpretations of guidelines leading to incorrect diagnosis of brain death: a case report and discussion. J Child Neurol 2020; 35:49–54.
Grzonka P, Tisljar K, Rüegg S, et al. What to exclude when brain death is suspected. J Crit Care 2019; 53:212–217.
Krawiec C, Ceneviva GD, Thomas NJ. Assessing and improving documentation of pediatric brain death determination within an electronic health record. Neuropediatrics 2019; 50:80–88.
Entry Date(s):: Date Created: 20201003 Date Completed: 20210216 Latest Revision: 20210216
Update Code:: 20240105
DOI:: 10.1097/MOP.0000000000000952
PMID:: 33009123
: Czasopismo naukowe

Purpose of Review: Death by neurologic criteria (DNC) is the irreversible cessation of all functions of the entire brain, including the brainstem. It is legally recognized as equivalent to cardiopulmonary death. Legal and ethical controversies surrounding DNC have emerged as a result of several highly publicized cases that have eroded public trust in our ability to declare DNC accurately. In this review, we focus on recently published primary data about DNC and address some of these controversies.
Recent Findings: Approximately 21% of children who die in pediatric intensive care units (PICU) are declared DNC. Although 60% of physicians report that they have been asked to maintain organ support after DNC declaration, less than 1% of patients remain physically present in the PICU more than 5 days after DNC declaration. We discuss strategies for safely conducting the apnea test, indications and prevalence of ancillary testing, and objections to DNC, including issues of consent and requests for ongoing organ support.
Summary: In order to maintain public trust, published guidelines must be followed to accurately and consistently diagnose DNC. We must develop strategies to respond to objections to DNC determination. Ongoing research is needed to improve the safety of apnea testing and indications for and interpretation of ancillary testing.

Informacja