Abstract:

Objective To discuss the clinical diagnostic criteria of brain death. Methods The brain death diagnosis was made in 12 patients who were in irreversible and unresponsive coma of identifiable cause. Thepotential reversible coma due to any damage or confounding factors was also excluded. The full clinical examinationof patients demonstrated irreversible and unresponsive coma，absence of brain stem reflexes，and apnea. Theessential findings of the ancillary test verifying brain death were as follows: Short Latency Somatosensory Evoked Potentials（SLSEP）from median nerve stimulation indicated that N9 and/or N13 waves were present，but no wavesfollowing P14，N18 and N20 were recordable. Electroencephalography（EEG）showed the absence of electrical activity. Transcranial Doppler Ultrasonography（TCD）confirmed brain death by small systolic peaks in early systole without diastolic flow，or reverberating flow in both anterior and posterior circulations. The patients demonstrated positive results at least two of the above three tests. Patients were diagnosed with brain death after the first round of confirmation was completed when the results of clinical examination and ancillary tests all met the diagnostic criteria for brain death. A second clinical examination and repeated ancillary tests were carried out 12 hours after the first round of confirmation，and the results still met the standards and then brain death was confirmed. Results Twelve patients all met the diagnostic criteria of brain death. Conclusion Clinical diagnosis of brain death is a highly rigorous and scientific work. Medical professionals must closely and strictly follow the brain death criteria to determine brain death.