![]() ![]() The understanding that brain death is equivalent to death helps guide decision-making for both physicians and patients' families regarding the withdrawal of care and prevents the unnecessary expenditure of resources. It is essential to distinguish the term "brain death" from "coma" to the public, as coma may imply a limited form of life. Brain death criteria also differ based on the patient's age. Therefore, different criteria are in effect to perform a document of brain death, and the provider should be cognizant of their country/state's criteria for a specific patient's age. ![]() ![]() However, internationally and even within different states of the United States, there is no uniformity to certify brain death. In 2012, the World Health Organization (WHO) partnered with an international forum to endorse brain death as the official diagnosis of death. AAN, in addition, believes "preserved neuroendocrine function may be present despite irreversible injury of the cerebral hemispheres and brainstem and is not inconsistent with the whole brain standard of death." The American Academy of Neurology (AAN) published the initial standards in 1995, which were updated in 2010 to the current standards.ĪAN's recent position statement on brain death endorses UDDA's death definition as "irreversible loss of entire brain, including the brainstem, has been determined by the demonstration of complete loss of consciousness (coma), brainstem reflexes, and the independent capacity for the ventilatory drive (apnea), in the absence of any factors that imply possible reversibility." Irreversibility in the definition of death refers to the impossibility of recovery, regardless of any medical intervention, which requires clear elaboration, as with the advancement of mechanical ventilation and life support technologies during the 20th century, patients who suffered severe brain damage could be maintained physiologically for prolonged periods in intensive care units (ICUs). The UDDA was drafted in the late 1970s in response to medical advances in life support that allowed for complete circulatory and respiratory support despite complete cessation of brain function. The UDDA did not establish what "accepted medical standards" were instead, only that they existed. Irreversible cessation of all functions of the entire brain, including the brainstem, is dead. ![]()
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