Castillo-de la Cruz M

Language: Spanish
References: 19
Page: 27-36
PDF size: 389.79 Kb.

ABSTRACT

The diagnosis of brain death does not only involve a neurological examination to determine whether the brain and brainstem retain their functions clinically. It should be conceptualized as a procedure to certifying the patient death and confirmation of all prerequisites established in the medical literature should be carried out, before considering doing the clinical tests and carrying out neurophysiological or image studies. It is out of question to establish that it is enough to perform a single neurological examination in which the patient does not show a clinical response to make the diagnosis, no matter if is a qualified specialist who dictates it, we must adhere to the clinical practice guidelines and articles that establishes the General Health Law of our country to certify the brain death. However, some recommendations are necessary in order not to delayed a brain death certification procedure for the purpose of transplants and includes an early initial assessment in patients with acute intracranial catastrophic injuries, confirmed in a simple tomography study; omitting the need for a second assessment and performing early complementary studies that should be individualized in each case and depend on the clinical conditions of the patient the selection of that study, as well as the availability of the hospital where they are. The specialist in neurology or neurosurgery should not be considered as the only ones qualified to make the certification of loss of life for the disposition of organs, tissues and cells for the purpose of transplants; specialists in emergency medicine, anesthesiology and critical medicine, radiologists with experience in the realization and interpretation of confirmatory image studies, all of them must be included. Healthcare professionals, in their assessment and management, could identify the absence of neurological responses in patients and have an active participation in order to safeguard the function of the organs of these patients and get improve the care and quality of life of those who require a transplant and has a desire to live.

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