P.050 Perspectives on the use of ancillary tests for determining neurological death: a survey of Canadian intensivists
| Autor: | J Neves Briard, M Yu, LP Carvalho, SW English, F d’Aragon, F Lauzier, A Turgeon, S Dhanani, L McIntyre, SD Shemie, G Knoll, DA Fergusson, SJ Anthony, MJ Weiss, M Chassé |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques. 48:S33-S33 |
| ISSN: | 2057-0155 0317-1671 |
| DOI: | 10.1017/cjn.2021.331 |
| Popis: | Background: Ancillary tests are indicated to diagnose death by neurological criteria whenever clinical neurological examination is unreliable, but their use is variable and subject to debate. Methods: Survey of Canadian intensivists providing care for potential organ donors. We included closed-ended questions and different clinical scenarios regarding the use of ancillary tests. Results: Among 550 identified intensivists, 249 completed the survey. Respondents indicated they would be comfortable diagnosing death based on neurological examination without ancillary tests in the following scenarios: movement in response to stimulation (48%), spontaneous peripheral movement (31%), inability to evaluate upper/lower extremity responses (34%) or both oculocephalic and oculo-caloric reflexes (17%), presence of high cervical spinal cord injury (16%) and within 24 hours of hypoxemic-ischemic brain injury (15%). Furthermore, 93% agreed that ancillary tests should always be conducted when a complete neurological examination is impossible, 89% if there remains possibility of residual sedative effect and 59% in suspected isolated brainstem death. Conclusions: Our findings suggest that Canadian intensivists have different perceptions on what constitutes a complete and reliable clinical neurological examination for determining death by neurologic criteria. Some self-reported practices also diverge from national recommendations. Further investigation and education are required to align and standardize medical practice across physicians and systems. |
| Databáze: | OpenAIRE |
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