Brain death guidance updated for first time in a decade

The American Academy of Neurology recently updated the guidelines for determining brain death in adult and pediatric patients.

The guidelines, published Oct. 11 in Neurology, are the first updates in more than a decade. The 85 consensus practice guidelines were developed by a panel of 20 experts from various specialities and institutions. It included a three-page checklist to use in evaluations.

As with previous guidelines, the updates said brain death should be declared when a patient with a known cause of catastrophic brain injury has permanent loss of function in the brain. This includes coma, brain stem areflexia and apnea.

The guidelines clarify questions on neurological examinations and apnea tests and evaluation of brain death in patients who are pregnant, on extracorporeal membrane oxygenation or have an injury to the base of the brain.

Clinicians also do not need to obtain consent before performing a brain death evaluation unless institution policy, state laws or regulations stipulate otherwise.

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