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2020, Number 3

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Arch Neurocien 2020; 25 (3)

Review about the new practical clinical guideline 2019 of brain death in Mexico

Castillo-de la Cruz M, Barrientos-Núñez ME
Full text How to cite this article

Language: Spanish
References: 13
Page: 79-84
PDF size: 329.64 Kb.


Key words:

CPG 2019, brain death, observations, ANN 2010 criteria.

ABSTRACT

The National Center of Technological Excellence (CENETEC) provides us within the master catalog of Clinical Practice Guidelines GPC-SS-488-19, the new Clinical Practice Guideline (CPG) that is now titled: Brain Death Diagnosis and Potential Management organ donor. With all the current evidence and recommendations that were reviewed by experts in the field, the guide that is titled Brain Death of the CPG 2011 is outdated.
The guide is intended for second and third level doctors of care and establishes that the diagnosis of brain death (BD) can be made by any doctor; however, this may not be so easy, even for the experts mentioned in the guide.
We consider it unfortunate to have excluded BD certification for the pediatric population from the new CPG and only focused on the adult population; This does not make it practical for the purpose of organ donation and transplantation in this age group. So, the 2011 Brain Death CPG will continue in this regard.
Having unified the theme of BD with the recommendations of the management of the potential donor favors that health professionals do not fall into the clinical nihilism of "not doing more for the patient with probable brain death" since the viability of the organs is compromised donated for transplant purposes; since not maintaining an adequate temperature, hemodynamic support and oxygenation acceptable in the donor cadaver, has fatal consequences on the viability of donated organs for transplants.


REFERENCES

  1. Diagnóstico de Muerte Encefálica. México: Secretaría de Salud, 2011. Disponible en www.cecetec.salud.gob.mx/ interior/gpc.html

  2. Resquena-Mena P. El diagnóstico de muerte cerebral. En persona y bioética. 2009;13(2):128-136.

  3. Ad Hoc Committee of the Harvard Medical School to examine the definition of brain death. A definition of irreversible coma. JAMA 1968; 205: 337-40.

  4. Castillo-de la Cruz M. Muerte encefálica y trasplante de órganos. Recomendaciones para los profesionales de la Salud. Revista Mexicana de Trasplantes 2018;8 (1):27-36. En http://www.medigraphic.com/trasplantes.

  5. Diagnóstico de muerte encefálica y manejo del potencial donante de órganos. Guía de Práctica Clínica: Evidencias y Recomendaciones. México, CENETEC; 2019. Disponible en: http://www.cenetec-difusion.com/CMGPC/GPCSS- 488-19 /ER.pdf

  6. Navarro-Bonnet J, Cervantes-González AI, Ruíz-Sandoval JL y Gómez-Amador JL. Muerte encefálica- Elementos clínicos y métodos auxiliares para su diagnóstico. Arch Neurocien (Mex) 2015;20(2):148-154.

  7. Shappell CN, Frank JI, Husari K, Sanchez M, Goldenberg F y Ardelt A. Practice variability in brain detah determination. Neurology 2013; 81:2009-2014.

  8. Wang HH, Varelas PN, Henderson GV, Wijdicks EF y Greer DM. Improving uniformity in brain death determination policies over time. Neurology 2017;88:562-568.

  9. Baumgartner H y Gerstenbrand F. Diagnosing brain death without a neurologist. BMJ 2002;324:1471-2.

  10. Resnick S, Seamon MJ, Holena D, Pascual J, Reilly P y Martin ND. Early declaration of death by neurologic criterio results in greater organ donor potential. J Sur Res. 2017;218:29-34.

  11. Principios rectores de la OMS sobre trasplante de células, tejidos y órganos humanos. https://www.who.int/ transplantation/TxGP%2008-sp.pdf

  12. Ley General de Salud de México. http://www.salud.gob.mx/cuts/pdfs/LEY_GENERAL_DE_SALUD.pdf

  13. Ying-Ying S y Guo-Guang Z. Criteria and Practical guidance for determination of brain death in adults (2nd edition). Brain Injury Evaluation Quiality Control Ceter of National Health Commision; Neurocritical Care Comitte of Chinese Society of Neurology (NCC/CSN);Neurocritical Care Comité of China Neurologist Association (NCC/ CNA). Chinese Medical Journal 2019;132(3):329-335.




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