Single or dual brain death exams: Tertiary hospital experience over 11.5 years
Brady P, Kananeh M, Louchart L, Mehta C, Rehman M, Lewis A, Greer D, Mayer S, and Varelas P. Single or dual brain death exams: Tertiary hospital experience over 11.5 years. Neurology 2018; 90(15 Suppl 1):P4.326.
Objective: To evaluate adoption of and reason for performing a single brain death exam (SBD) vs two (dual) brain death exams (DBD) and their impact on organ function and consent for organ donation. Background: Our hospital policy allows an optional SBD (with an apnea and a cerebral blood flow test) or a DBD (with an apnea test). Design/Methods: We evaluated our hospital's BD registry between January 2006 and June 2017 regarding SBD or DBD. We also cross-matched our electronic medical records with the records of the local organ procurement organization. Results: Of 251 BD declarations, 115 (46%) were SBD and 136 (54%) DBD. During the 1 five years, 43% of all BD exams were SBD and during the second 57%. Patients with SBD were older (50.6±16.5 for SBD vs 46.5±17.1 years for DBD, p= 0.057), had a primary neurologic diagnosis (96% vs 47%, p< 0.001) and were admitted to the Neuro- ICU (74% vs 27%, p< 0.001). During the 2 exam, 76.7% patients were on equal or higher dose of pressors. SBD patients had lower K+, BUN, creatinine and heart st nd rate, but higher peak Na+ and apnea PaO2 (for all p
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