Brain death: Our experiences in intensive care unit
Fatma Irem Yesiler1, Behiye Deniz Kosovali2, Mustafa Kemal Bayar3
1Baskent University Intensive Care Unit Department of Anesthesiology and Reanimation, Ankara, Turkey
2Malatya Education and Research Hospital Department of Intensive Care Unit, Malatya, Turkey
3Ankara University Faculty of Medicine Department of Anesthesiology and Reanimation Intensive Care Unit, Ankara, Turkey
Aim: The aim of this study was to examine patients retrospectively with brain death (BD) who were diagnosed in our intensive care unit (ICU).
Material and Methods: This retrospective descriptive study evaluated 24 patients with diagnosed BD in the ICU between January 2012 and December 2015 using digital patient records. We registered demographic, clinical and laboratory findings, Acute Physiology and Chronic Health Evaluation System (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, Glasgow Coma Score (GCS), development of complications, donation rate, time of BD diagnosis and length of ICU stay.
Results: Twenty-four patients (11 males, 13 females) with BD whose ages were between 24–83 years old. The etiologies of BD diagnosis were medical causes in 20 cases (83.3 %) and traumatic causes in 4 cases (16.7 %). Subarachnoid haemorrhage due to a cranial aneurysm was the most common cause of ICU admission (n = 6). The mean APACHE II score was 16 ± 5.2, GCS was 4.25 ± 2.5, and the SOFA score was 8.4 ± 3.5 on ICU admission. The mean time of BD diagnosis was 147.8 ± 19 hours and the mean length of ICU stay was 8.8 ± 7.7 days. Confirmatory tests (cranial angiography, cranial Doppler, cranial CT angiography) were performed on 16 patients. The acceptance rate for organ donation was 45.8% (n = 11).
Conclusion: The intensivist should target to both confirm and declare the diagnosis of BD in the shortest time and increase the number of organs transplanted per donor.
Keywords: Brain Death; Donor Rate; Intensive Care Unit.