PEDIATRICS Vol. 78 No. 1 July 1986, pp. 107-112
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Determination of Cerebral Death in the Pediatric Intensive Care Unit

Beth Drake MD1, Stephen Ashwal MD1, and Sanford Schneider MD1

1 From the Division of Child Neurology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, California

The clinical course, laboratory data, outcome, and autopsy findings in 61 pediatric patients with suspected brain death were reviewed. In 58% of patients, the initial EEG was isoelectric, and cerebral blood flow was absent. In six of nine children, the initial EEG, which showed activity, became isoelectric by 72 hours. In no child without demonstrable cerebral flow did flow resume in later studies. In four of five children who had initial EEG activity despite absent cerebral flow, an isoelectric EEG developed on repeated study. The average time from initial insult until clinically suspected brain death was 29.5 hours and 61.5 hours until brain death was confirmed. The time from confirmation of brain death until discontinuation of life support systems was 32 hours in the majority of patients. Our current protocol for evaluating pediatric patients with suspected brain death is reviewed with emphasis on the clinical examination, laboratory studies, and use of serial EEGs and radionuclide cerebral blood flow determinations.

Key Words: brain death • cerebral blood • intensive care unit

Accepted on November 13, 1985


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