In collaboration with the American Academy of Pediatrics (AAP), Child Neurology Society (CBS), and Society for Critical Care Medicine (SCCM), the American Academy of Neurology (AAN) has updated the evidence and consensus-based guideline for pediatric and adult brain death/death by neurologic criteria (BD/DNC) determination.
The 2023 guideline uses the term BD/DNC instead of the term “brain death” to acknowledge both how it’s normally referenced by most people and to draw parallels to death by cardiopulmonary criteria. It also uses the term “permanent” rather than “irreversible” to describe the severity of brain injury necessary to determine BD/DNC. It interprets death as a “loss of function of the brain as a whole, including the brainstem, resulting in coma, brainstem areflexia, and apnea.”
One of the most significant changes was the decision that EEG is not an acceptable test for either pediatric or adult BD/DNC determination because of a concern that while it assesses function of the cerebral cortex, it does not evaluate brainstem function.
New topics in the 2023 guidelines include elevated intracranial pressure, targeted temperature management treatment, and the use of ECMO (extracorporeal membrane oxygenation), a form of life support for people with life-threatening illnesses or injuries that impair heart or lung function.
Read more here: https://cp.neurology.org/content/13/6/e200189
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