Determination of Brain Death: An Overview with a Special Emphasis on New Ultrasound Techniques for Confirmatory Testing

Abstract

Progress in resuscitation medicine and the widespread success of cardiopulmonary support in intensive care medicine called for new standards for determining a patients death. Following a worldwide discussion on the medical, ethical, and legal aspects of death, the term brain death is now a generally accepted criterion for death. Brain death, defined as complete and irreversible cessation of brain function was established to describe an individuals death even during artificial ventilation and a temporary maintenance of cardiac function in the ICU setting. The determination of brain death requires adequate prerequisites, as well as clinical findings verifying a complete loss of function of the entire brain, and a confirmation of its irreversibility. Most countries have national guidelines aimed at providing a high-quality medical standard and to exclude any conflicts of interest. On confirmation of brain death, life-sustaining therapies are discontinued in accordance with the declared or assumed will of the dead individual. Only in cases of an intended organ donation, organ protective measures need to be continued until surgery. In this overview, we aim to outline the components of determining clinical brain death with a special emphasis on new ultrasound techniques for confirmatory testing.