Nuclear Medicine Cerebral Perfusion Studies as an Ancillary Test to Support Evaluation of Brain Death/Death by Neurologic Criteria: Single-Center Experience in Infants, 2005-2022.

Autor:	Bach AM; Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA., McKinnon NK; Department of Critical Care Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada., Zhuang H; Division of Nuclear Medicine, Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA., Kaufman E; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA., Kirschen MP; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA.
Jazyk:	angličtina
Zdroj:	Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [Pediatr Crit Care Med] 2024 Dec 01; Vol. 25 (12), pp. 1089-1095. Date of Electronic Publication: 2024 Dec 04.
DOI:	10.1097/PCC.0000000000003596
Abstrakt:	Objective: To describe the use of nuclear medicine cerebral perfusion studies as an ancillary test for brain death/death by neurologic criteria (BD/DNC) in infants aged under 1 year. Design: Retrospective case series. Setting: Single-center, quaternary, academic children's hospital in the United States. Patients: Patients younger than 1 year of age whose evaluation for BD/DNC included a nuclear medicine cerebral perfusion study as an ancillary test, 2005-2022. Interventions: None. Measurements and Main Results: Ten infants were identified from local databases. Mechanisms of brain injury included hypoxic-ischemic injury (8/10), traumatic brain injury (1/10), and intracranial hemorrhage (1/10). Testable components of the first BD/DNC examination were consistent with BD/DNC in all patients. Apnea testing was consistent with BD/DNC in 5 of 10 patients and deferred or terminated prematurely in 5 of 10 patients. All patients underwent ancillary testing with a nuclear medicine scan to assess cerebral perfusion using 99mTc-ethyl cysteinate dimer (99mTc-ECD). Indications were inability to complete the apnea test (5/10), presence of a confounder to the clinical examination (3/10), and clinician discretion (2/10). Nine studies were consistent with BD/DNC. The patient whose ancillary test was inconsistent with BD/DNC had their examination limited by the inability to assess the pupillary reflex and subsequently underwent withdrawal of life-sustaining technology. Conclusions: Radionuclide cerebral perfusion studies using 99mTc-ECD were used in our setting to support the determination of BD/DNC in infants aged younger than 1 year of age. Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.)
Databáze:	MEDLINE
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