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Evaluation of Patients with Brain Death Diagnosis and Investigation of the Effect of New Regulation on the Duration of Diagnosis
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Original Research
VOLUME: 18 ISSUE: 1
P: 21-27
March 2020

Evaluation of Patients with Brain Death Diagnosis and Investigation of the Effect of New Regulation on the Duration of Diagnosis

J Turk Soc Intens Care 2020;18(1):21-27
DOI: 10.4274/tybd.galenos.2019.09825
Savaş Altınsoy
Elif Şule Özdemir
İlkay Baran
Fatma Kavak Akelma
Mukaddes Tuğba Arslan
Jülide Ergil
1. Sağlık Bilimleri Üniversitesi, Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Ankara, Türkiye
2. University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Qlinic of Anestehesiology and Reanimation, Ankara, Turkey
3. Kavak Akelma, Mukaddes Tuğba Arslan, Julide Ergil Sağlık Bilimleri Üniversitesi, Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Ankara, Türkiye
No information available.
No information available
Received Date: 12.02.2019
Accepted Date: 25.05.2019
Publish Date: 20.02.2020
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ABSTRACT

Objective:

Today, the number of patients waiting for organ transplantation is increasing. The detection of brain death in a cadaveric donor is valuable and should be performed quickly. In 2014, Turkish Ministry of Health introduced new regulation on the detection of brain death. With this regulation, it was decided that the medical death that was previously diagnosed by four physicians is now unanimously diagnosed by two physicians in accordance with the evidencebased medicine rules. In this study, we aimed to determine whether the current regulation change has an effect on the duration of brain death diagnosis and the number of donors.

Materials and Methods:

After obtaining the approval of the local ethics committee, the data of patients diagnosed with brain death in our hospital between 2009-2018 were examined. Patients with missing files were excluded from the study. The demographic data of the patients, time of hospitalization, brain death diagnosis time, donor status, tests performed for the diagnosis, physicians named in the brain death detection report and the time of cardiac death were noted. All cases were divided into two groups as “before 2014” (group 1) and “after 2014” (group 2).

Results:

In this study, 118 patients were included. Nineteen (16.1%) of the patients were children (<18 years) and 99 (83.9%) were adults. There were 67 patients (55.9%) in group 1 and 51 patients (44.1%) patients in group 2. The time of diagnosis was longer in group 1 (4.82±3.6 days) than group 2 (2.3±1.72 days) (p<0.05). Both groups were similar in terms of time of cardiac arrest after diagnosis (p>0.05). Intracranial hemorrhage was the most common cause of hospitalization in both groups.

Conclusion:

In this study, new regulation in 2014 made a positive contribution to the time of diagnosis of brain death and shortened this period in our hospital.

Keywords: Brain death, diagnosis time, apnea testing, organ donation

References

1
Drake M, Bernard A, Hessel E. Brain Death. Surg Clin North Am 2017;97:1255-73.
2
Citerio G, Murphy PG. Brain Death: The European Perspective. Semin Neurol 2015;35:139-44.
3
T.C. Resmi Gazete. Organ ve Doku Nakli Hizmetleri Yönetmeliği. 01 Şubat 2012. Resmi Gazete Sayısı: 28191. Erişim adresi: www.ttb.org.tr/mevzuat/index.php?option=com
4
Sağlık Bakanlığı Organ, doku nakli ve diyaliz hizmetleri daire başkanlığı. Erişim tarihi: 01.05.2015. Erişim adresi: https://shgm.saglik.gov.tr
5
Battal M, Horoz A, Karatepe O, Çitgez B. Beyin ölümü tespitinde araştırma hastanesi deneyimi. Şişli Etfal Hastanesi Tıp Bülteni 2013;47:59-62.
6
Karasu D, Yılmaz C, Karaduman İ, Cınar YS, Pekel NB. Beyin Ölümü Olgularının Retrospektif Analizi. Yoğun Bakım Derg 2015;6:23-6.
7
A definition of irreversible coma. Raport of the ad hoc Committee of the Harvard Medical School to examine the definition of brain death. JAMA 1968;205:337-40.
8
Thery G, Rosman J, Julien G, Chaix F, Mateu P. Brain death: Bilateral pneumothorax and pneumoperitoneum after an apnoea test. Anaesth Crit Care Pain Med 2019;38:89-90.
9
Sołek-Pastuszka J, Sawicki M, Iwańczuk W, Kojder K, Saucha W, Czajkowski Z, et al. Apnea testing using the oxygen insufflation method for diagnosis of brain death may compromise pulmonary function. J Crit Care 2018;44:175-8.
10
Datar S, Fugate J, Rabinstein A, Couillard P, Wijdicks EF. Completing the apnea test: decline in complications. Neurocrit Care 2014;21:392-6.
11
Giani M, Scaravilli V, Colombo SM, Confalonieri A, Leo R, Maggioni E, et al. Apnea test during brain death assessment in mechanically ventilated and ECMO patients. Intensive Care Med 2016;42:72-81.
12
Dosemeci L, Yilmaz M, Cengiz M, Dora B, Ramazanoğlu A. Brain death and donor management in the intensive care unit: experiences over the last 3 years. Transplant Proc 2004;36:20-1.
13
Güzeldağ S, Koca U, Ergör OA, Akan M. Erişkin beyin ölümü olgularının retrospektif analizi. Turkiye Klinikleri J Med Sci 2014;34:47-52.
14
Wijdicks EF. Brain death worldwide: accepted fact but no global consensus in diagnostic criteria. Neurology 2002;58:20-5.
15
Greer DM, Varelas PN, Haque S, Wijdicks EF. Va- riability of brain death determination guidelines in lea- ding US neurologic institutions. Neurology 2008;70:284-9.
16
Mathur M, Ashwal S. Pediatric brain death determination. Semin Neurol 2015;35:116-24.
17
Burns JP, Sellers DE, Meyer EC, Lewis-Newby M, Truog RD. Epidemiology of death in the P1CU at five U.S. teaching hospitals. Crit Care Med 2014;42:2101-8.
18
Özmert S, Sever F, Ayar G, Yazıcı MU, Öztaş DK. Brain death and organ donation in pediatric intensive care unit. Turk J Anaesthesiol Reanim 2019;47:55-61.
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