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Brain-Death Criteria Currently Used by Pediatric IntensivistsMarshall University School of Medicine, Pediatric Department, Huntington, West Virginia
University of Illinois College of Medicine, Department of Pediatrics, Peoria, Illinois 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.
Clinical Pediatrics, Vol. 31, No. 8,
457-460 (1992) This article has been cited by other articles:
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