• Neurocritical care · Apr 2021

    Ancillary Testing for Determination of Death by Neurologic Criteria Around the World.

    • Ariane Lewis, Jordan Liebman, Elana Kreiger-Benson, Andrew Kumpfbeck, Azza Bakkar, Sam D Shemie, Gene Sung, Sylvia Torrance, and David Greer.
    • Division of Neurocritical Care, Departments of Neurology and Neurosurgery, NYU Langone Medical Center, 530 First Avenue, HCC-5A, New York, NY, 10016, USA. ariane.kansas.lewis@gmail.com.
    • Neurocrit Care. 2021 Apr 1; 34 (2): 473-484.

    ObjectiveWe sought to identify similarities and differences in the diagnostic requirements for ancillary testing for determination of brain death/death by neurologic criteria (BD/DNC) around the world.MethodsWe reviewed diagnostic requirements for ancillary testing for BD/DNC in 78 unique official national BD/DNC protocols obtained from contacts worldwide between January 2018 and April 2019.ResultsDetails provided on the performance and interpretation of ancillary tests for determination of BD/DNC were variably provided and inconsistent. Approximately half of all protocols that included each ancillary test provided details about study performance: 63% of protocols that included conventional cerebral angiography, 55% of protocols that included electroencephalography, 50% of protocols that included somatosensory evoked potentials, 48% of protocols that included transcranial Doppler ultrasonography, 43% of protocols that included nuclear medicine flow study and 41% of protocols that included brainstem auditory evoked potentials. Similarly, about half of all protocols that included each ancillary test provided details about study interpretation: 66% of protocols that included electroencephalography, 59% of protocols that included brainstem auditory evoked potentials, 56% of protocols that included somatosensory evoked potentials, 55% of protocols that included transcranial Doppler ultrasonography, 52% of protocols that included conventional cerebral angiography and 49% of protocols that included nuclear medicine flow study.InterpretationDiagnostic requirements for ancillary testing in BD/DNC determination vary around the world. We hope that the World Brain Death Project will improve worldwide consensus on the diagnostic requirements for ancillary testing in BD/DNC, both for performance and interpretation.

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