Abstracts fromThe 29 th Annual National Neurotrauma Symposium July 10–13, 2011 Hollywood Beach, Florida

Abstract

INTRODUCTION: In Muslim patients, end of life care in brain dead patients is not defined. We conducted this study to look at the outcome of Muslim brain dead patients in our non-trauma tertiary care hospital. METHODS: We retrospectively collected clinical data for all adult patients who were declared brain dead between January 2001 and March 2011. RESULTS: A total of forty patients were found. The average age was 45 years, 22 male and 18 female. Twenty patients had intra-cranial hemorrhage, five had cerebral neoplasm and rest of the patients had miscellaneous etiologies like anoxic brain injury. The average time from admission to diagnosis of brain death was 7.6 days. Per hospital policy, two attending physicians are required to confirm brain death. Five patients expired before completion of the protocol. In rest of the patients, it was completed by an Intensivist and the second physician was either Neurologist (67%) or Neurosurgeon (33%). Electroencephalogram was used as a confirmatory test in all patients, except five who had an additional perfusion scan done. 25 patients were “Full Code” before brain death confirmation. However, after brain death three patients remained “Full Code”, nineteen had “Do Not Resuscitate (DNR)” orders and eighteen had DNR with limitations on vasopressors. Ventilator withdrawal occurred only in eleven patients. Average time to death from confirmation of brain death was two days. 24 patients were eligible for organ donation, however only two had organs harvested. There was no involvement of social worker or chaplain in the end of life discussions. CONCLUSION: Our experience shows that even though the diagnosis of brain death follows international standards, the care afterwards is yet to be defined in Muslim patients. The concept of terminal withdrawal and organ donation is not accepted by most of the families. Future studies should focus to improve these issues.