Determination of Brain Death/Death by Neurologic Criteria in Countries in Asia and the Pacific.
Asia
brain death
death
policy
Journal
Journal of clinical neurology (Seoul, Korea)
ISSN: 1738-6586
Titre abrégé: J Clin Neurol
Pays: Korea (South)
ID NLM: 101252374
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
11
02
2020
revised:
06
05
2020
accepted:
07
05
2020
entrez:
14
7
2020
pubmed:
14
7
2020
medline:
14
7
2020
Statut:
ppublish
Résumé
We sought to 1) identify countries in Asia and the Pacific that have protocols for the determination of brain death/death by neurologic criteria (BD/DNC) and 2) review the similarities and differences of these protocols in different countries. Between January 2018 and April 2019, we attempted to communicate with contacts in the 57 countries in Asia and the Pacific to determine if they had official national BD/DNC protocols. We reviewed and compared the identified protocols. We identified contacts for 40 (70%) of the 57 countries in Asia and the Pacific, and successfully communicated with 37 of them (93% of countries with contacts identified, 65% of countries in Asia and the Pacific). We found that 24 of the 37 countries had BD/DNC protocols. Two (13%) of the 16 protocols that provided a definition of death referred to brainstem death. Kazakhstan and Israel required only 1 examination to declare BD/DNC, while 10 (71%) of the other 14 protocols required 2 examinations separated by 6-48 hours. The prerequisites, clinical examination, apnea testing procedure, and indications for/selection of ancillary tests varied. Ancillary testing was required for all determinations of BD/DNC in five (21%) countries. Thirteen (54%) of the protocols included information about the time of death, while 12 (50%) of them provided instructions about discontinuation of organ support. The protocols for conducting a BD/DNC determination vary markedly among countries in Asia and the Pacific. Since it is optimal to have internationally and intranationally consistent BD/DNC protocols, efforts should be made to harmonize protocols both within this region and worldwide.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
We sought to 1) identify countries in Asia and the Pacific that have protocols for the determination of brain death/death by neurologic criteria (BD/DNC) and 2) review the similarities and differences of these protocols in different countries.
METHODS
METHODS
Between January 2018 and April 2019, we attempted to communicate with contacts in the 57 countries in Asia and the Pacific to determine if they had official national BD/DNC protocols. We reviewed and compared the identified protocols.
RESULTS
RESULTS
We identified contacts for 40 (70%) of the 57 countries in Asia and the Pacific, and successfully communicated with 37 of them (93% of countries with contacts identified, 65% of countries in Asia and the Pacific). We found that 24 of the 37 countries had BD/DNC protocols. Two (13%) of the 16 protocols that provided a definition of death referred to brainstem death. Kazakhstan and Israel required only 1 examination to declare BD/DNC, while 10 (71%) of the other 14 protocols required 2 examinations separated by 6-48 hours. The prerequisites, clinical examination, apnea testing procedure, and indications for/selection of ancillary tests varied. Ancillary testing was required for all determinations of BD/DNC in five (21%) countries. Thirteen (54%) of the protocols included information about the time of death, while 12 (50%) of them provided instructions about discontinuation of organ support.
CONCLUSIONS
CONCLUSIONS
The protocols for conducting a BD/DNC determination vary markedly among countries in Asia and the Pacific. Since it is optimal to have internationally and intranationally consistent BD/DNC protocols, efforts should be made to harmonize protocols both within this region and worldwide.
Identifiants
pubmed: 32657070
pii: 16.480
doi: 10.3988/jcn.2020.16.3.480
pmc: PMC7354977
doi:
Types de publication
Journal Article
Langues
eng
Pagination
480-490Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Informations de copyright
Copyright © 2020 Korean Neurological Association.
Déclaration de conflit d'intérêts
The authors have no potential conflicts of interest to disclose.
Références
Neurology. 2015 May 5;84(18):1870-9
pubmed: 25854866
Intensive Care Med. 2014 Jun;40(6):788-97
pubmed: 24664151
JAMA. 1968 Aug 5;205(6):337-40
pubmed: 5694976
Neurology. 2015 May 5;84(18):1878
pubmed: 25854869
J Relig Health. 2020 Feb;59(1):96-112
pubmed: 31317465
Neurology. 2020 Jul 21;95(3):e299-e309
pubmed: 32576632
Chin Med J (Engl). 2015 Nov 5;128(21):2896-901
pubmed: 26521787
J Crit Care. 2015 Feb;30(1):107-10
pubmed: 25131939
Semin Neurol. 2015 Apr;35(2):152-61
pubmed: 25839724
Br Med J. 1968 Aug 24;3(5616):493-4
pubmed: 20791542
Neurocrit Care. 2020 Feb;32(1):172-179
pubmed: 31175567
Bioethics. 2012 May;26(4):215-23
pubmed: 20731646
JAMA Neurol. 2016 Feb;73(2):213-8
pubmed: 26719912
Indian J Crit Care Med. 2014 Sep;18(9):596-605
pubmed: 25249744
Transplantation. 2000 Jul 15;70(1):131-5
pubmed: 10919589
Neurocrit Care. 2014 Dec;21(3):376-82
pubmed: 24865268
Anesthesiology. 1999 Jul;91(1):326
pubmed: 10422968
J Clin Neurosci. 2008 May;15(5):580-2
pubmed: 18313926
Am J Respir Crit Care Med. 2014 Oct 15;190(8):855-66
pubmed: 25162767
Crit Care. 2008;12(2):210
pubmed: 18439321
Neurology. 2002 Jan 8;58(1):20-5
pubmed: 11781400
Curr Opin Crit Care. 2008 Jun;14(3):261-8
pubmed: 18467884