Brain Death
Conditions
Keywords
diagnosis of brain death
Brief summary
The aim of this study is to assess and survey the quality of the process required to diagnose brain death in adult patients. This study of adult patients diagnosed brain dead or suspected of having brain death on the ICUs at the University Hospital Basel will be purely observational.
Interventions
OTHERAssessment of process required to diagnose brain death in adult patients
Assessment of process required to diagnose brain death in adult patients (demographics, clinical, laboratory, imaging, and treatment data). No questionnaires or study visits will be used.
Sponsors
University Hospital, Basel, Switzerland
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients with suspected and/or diagnosed brain death * adults 18 years and over
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| adherence to the local brain death protocol ( = measurement tool) for the process of brain death diagnosis | single time point assessment at baseline (after suspected brain death) | the local brain death protocol ( = measurement tool) requires 1.) exclusion of the following conditions: * shock (mean arterial blood pressure \> 60 mmHg, lactate \< 4 mmol/l) * hypothermia (temperature \> 35°C) * severe acidosis (pH \> 7.3) * hyperosmolarity (osmolarity \< 320 mmol/l) * severe electrolyte disorders (sodium \> 125 mmol/l, phosphate \> 0.3 mmol/l) * hypoglycemia (glucose \> 4 mmol/l) * hyperammonemia (ammonia \< 60 mumol/l) * uremia (urea \< 25 mmol/l) * prolonged effects of medication (muscle relaxants, sedatives, recreational drugs) * severe hypothyreosis 2.) clinical examination confirming: * fixed pupils (dilated or mid-dilated bilaterally) * absent vestibulo-ocular reflex * absent corneal reflex bilaterally * no reaction to painful stimulus bilaterally * absence of cough and gag reflex * absence of spontaneous breathing (apnea test) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| number of physicians involved | single time point assessment at baseline (after suspected brain death) | number of physicians involved in the diagnostic procedures |
| frequency of ancillary tests performed | single time point assessment at baseline (after suspected brain death) | frequency of ancillary tests (i.e. transcranial doppler ultrasound, computed tomography, magnetic resonance tomography, digital substraction angiography, electroencephalogram, somatosensory evoked potentials) performed |
| number of work-ups excluding suspected brain death | single time point assessment at baseline (after suspected brain death) | number of work-ups excluding suspected brain death |
| number of diagnostic work-ups with insufficient performance and/or documentation | single time point assessment at baseline (after suspected brain death) | number of diagnostic work-ups with insufficient performance and/or documentation |
| years of clinical experience of physicians involved | single time point assessment at baseline (after suspected brain death) | years of clinical experience of physicians involved in the diagnostic procedures |
Countries
Switzerland
Outcome results
None listed