Pediatric brain death: Experience of a single center

Abstract

Objective: Brain death is defined as the irreversible loss of consciousness and all functions of the brain stem. The accuracy and urgency of a diagnosis of brain death in children are highly important, because of the increasing rate of organ transplantation. Our objective was to describe the features of cases where “brain death” was diagnosed in the last five years. Material and Methods: Demographical, clinical, electroencephalographic (EEG), Doppler ultrasonography and static single-photon emission computerized tomography (SPECT) characteristics were evaluated retrospectively in hospitalized with loss of brain stem functions and deep coma. Results: Twenty eight patients (8 girls/20 boys) were evaluated in this study. The median age was 72 months (10-210 months). Transcranial Doppler ultrasonography was performed in 18 (64%) patients. The cerebral catheter angiography was used in one patient. SPECT was used in eleven (40%) patients as a confirmatory test. Diabetes insipidus was present in 75% (n=21) and hypothermia was present in 50% (n=14) of the patients. Conclusion: We observed that serial Doppler Ultrasonography and SPECT benefited us more than other techniques in our study. Transcranial Doppler is useful and has some advantages: such as noninvasiveness, rapid application, easy bedside operation, portability, no disturbance from sedatives, repeatability and relatively low price. We conclude that diabetes insipidus may be an indicator of brain death, and an observation of diabetes insipidus should accelerate confirmatory tests and treatment immediately.