Definicja i rozpoznanie śmierci mózgu: porównanie wytycznych w różnych krajach

*Waldemar Iwańczuk

Summary
In most countries, brain death is defined as the irreversible and complete loss of brain function. The United Kingdom and Poland are the only countries where the irreversible arrest of brain stem function is regarded as equal to brain death. The concept of brain death being understood as the death of the patient is widely accepted however the guidelines for determining brain death differ somewhat in various countries.
The diagnosis of brain stem death is largely based on clinical examination. It is performed in three steps: establishing the aetiology of disease; excluding potentially reversible syndromes that may produce signs similar to brain stem death, including coma; and the lack of brain stem reflexes with persistent apnoea. The period between the first observation of signs of brain death, and the beginning of the diagnostic procedure varies in different countries, and may last from 2 to 72 h in cases of secondary brain damage. In Poland, the diagnosis is based on clinical observations and blood gas analysis confirming the apnoeic test, however in several European countries, additional instrumental testing is required by the law. Tests such as EEG, and scintigraphy of the brain are optional in adults, but recommended in children.
The paper presents similarities and differences in current concepts of brain death in various countries.

To jest tylko fragment artykułu. Aby przeczytać całość, przejdź do Czytelni medycznej.