Journal of Pediatric Emergency and Intensive Care Medicine (Aug 2018)
Evaluation of Patients Diagnosed with Brain Death in Pediatric Critical Care
Abstract
Introduction: The incidence of brain death in pediatric intensive care units is not known precisely. Studies of brain death-organ donation in children are few and the etiology of brain death in pediatric patients is different than in adults. Our aim was to present cases of brain death occurred in our pediatric intensive care unit in a two-year period and discuss the causes of organ donation failure. Methods: Medical reports of patients diagnosed with brain death between January 1, 2015 and December 31, 2016 in our pediatric intensive care unit were retrospectively reviewed. Data were screened according one age, gender, reason of hospitalization and mean duration of brain death evaluation. Results: A total of 806 patients were followed up in our pediatric intensive care unit in the two-year period. Of these patients, 83 (10.2%) died and brain death was detected in 14 (17%) of this patients. The mean duration of brain death was 2.14±1.16 days. The reasons for hospital admission were infection in 3 patients, asphyxia in 4 patients, malignancy in 4 patients, drowning in 2, and trauma in 1 patient. The mean age of the patients diagnosed with brain death was 6.96±5.53 (minimum: 0.6, maximum: 16 year) years. 6 patients (42.8%) were female and 8 patients (57.2%) were male. Doppler ultrasonography was used as an additional test for the diagnosis of brain death in 11 patients (78.6%). None of the patients became organ donor because of medical unsuitability and family disagreement. Conclusion: Due to high occupancy, trauma patients may rarely be found in our pediatric intensive care unit. Most of the brain deaths are caused by asphyxia (mostly food aspiration), malignancy and drowning in water (freshwater). The rate of organ donation in pediatric patients is lower than in adults. For this reason, it is even more important to increase the number of patients diagnosed with brain death in pediatric intensive care units. We believe that the awareness of brain death may increase if it is known that also diseases other than traumatic brain injury may cause brain death. We also believe that increased awareness of brain death determination and communication with patient relatives are necessary to increase the number of organ donation.
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