Brain death is the cessation of brain activity. What are the signs of brain death? What is the time limit for disconnecting the patient?
The term brain death or brain death designates the state in which the brain functions are shut down and the heart continues to function. This condition can be caused by cardiac arrest or a stroke, for example. It is possible to harvest organs on a brain-dead patient if agreement is proven. What are the signs of brain death? Can we wake up? What is the time to unplug a brain dead patient?
Definition: When do we speak of brain death?
Brain death or “brain death” refers to a condition in which all brain functions are shut down while the cardiac functions are maintained. THE patient then died.
What causes brain death?
Generally, brain deaths follow a prolonged lack of oxygen after cardiac arrest for example, traumatic brain injury or stroke. brain death is irreversible.
What are the signs of brain death?
“The context is important because this situation is only possible in a patient who is in intensive care. One cannot say of a person who died in the street that he is brain dead” warns Pr Sigismond Lasocki, anesthesiologist-resuscitator. Certain signs make it possible to affirm the state of brain death: “The patient is in a very deep coma, he has not no reaction, he has not no reflex and he don’t breathe on your own“, continues the resuscitator.
Is it possible to wake up from brain death?
“No, if you are dead, you are dead! What is possible, on the other hand, is to be in a state of apparent death (especially in the event of hypothermia…). To establish the brain death diagnosisthe patient must have no anesthetic medication circulating and that he is not hypothermic“, says the specialist.
“The patient is examined we check that he has no reactivity, no persistent archaic reflex, that he is not breathing on his own, we even do a blood test after the apnea test to check if there is carbon dioxide in the blood because some accumulates when you don’t breathe. All of these elements allow us to make the diagnosis of brain death. From this moment, we can clinically say that the patient is dead. His heart keeps beating cause it’s a muscle which has its own “battery” it continues to beat as long as it has enough oxygen to function, i.e. as long as the patient is hooked up to a machine to make him breathe”, explains the resuscitator.
It is possible to donate organs in a state of brain death
How long does it take to unplug in the event of brain death?
“The patient is dead, so continuing to make him breathe doesn’t make sense. When death is pronounced, there is no reason to wait to disconnect the patient. We can leave it while waiting for the family to come, but it’s symbolic”, emphasizes the specialist.
Brain death and organ donation
As soon as this clinical diagnosis has been established, the resuscitator can disconnect the machine and make the death certificate. But, as long as the patient is on a respirator, the blood is oxygenated and the organs are perfused: we can then organ removal. “However, this requires proof of brain death, either by making a electroencephalogram with at least 30 minutes of recording, twice, four hours apart, or by carrying out a cerebral angioscanner which proves to us that there is no longer any blood circulation in the brain. At that time, we discuss with relatives to find out if the patient whether or not they wanted to donate their organs“, nuance Professor Sigismond Lasocki.
Thank you to Pr Sigismond Lasocki, Anesthetist-Resuscitator doctor and head of the ASUR pole (Anesthesia, SAMU, Emergency Resuscitation) at the CHU d’Angers