Brain death, donor management

Abstract

Brain death is the irreversible cessation of all functions of the entire brain, including the brain stem. Brain death is accepted as a clinical death worldwide. Only a few countries do not accept it as a legal death and do not allow cessation of medical care or procurement of any organs before the heart stops. The major difference between laws and public view occurs when the possibility of cadaveric organ transplantation appears. Such a delicate subject requires a higher level of awareness from healthcare providers. Even minor hesitations during a talk about brain death cause major anxiety and suspicion in the relatives of the patient. Brain death is a diagnosis of exclusion, meaning that all other possible causes of coma or brain injury must be ruled out before brain death can be diagnosed. It is the impression of the author that this expression is understood by many physicians and nurses as that brain death is not a real diagnosis. It is the aim of this chapter to convince the reader that brain death is a real diagnosis, and the diagnostic process is an essential part of the daily routine of the intensive care unit.