Criteria and practical guidance for determination of brain death in adults (2nd edition)

• Published in: Chinese medical journal 2019-02, Vol.132 (3), p.329-335
• Main Authors: Peng Lyu, Brain Injury Evaluation Quality Control Center of National Health Commission, Neurocritical Care Committe of the Chinese Society of Neurology (NCC/CSN), Neurocritical Care Committe of China Neurologist Association (NCC/CNA)
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Brain death; Brain Death - diagnosis; China; Clinical Guideline; Coma; Cornea; Guidelines as Topic - standards; Humans; Light; Otolaryngology; Poisoning; Pulmonary arteries; Quality control; Respiration; Spinal cord; Trauma; Traumatic brain injury
• ISSN: 0366-6999; 2542-5641
• DOI: 10.1097/CM9.0000000000000014

In order to further promote the brain death related work, Brain Injury Evaluation Quality Control Center of National Health Commission (BQCC) aimed to revise and update “Criteria and practical guidance for determination of brain death in adults”. B. Exclusion of reversible coma The cause of reversible coma include acute intoxication, such as carbon monoxide poisoning, alcoholic poisoning, sedative hypnotic poisoning, narcotic poisoning, antipsychotic drug poisoning, and muscle relaxant poisoning; shock; hypothermia (bladder, rectal or pulmonary artery temperature ≤32 °C); severe electrolyte and acid-base disturbance; and severe metabolism and endocrine disturbance, such as hepatic encephalopathy, uremic encephalopathy, hypoglycemic encephalopathy, or hyperglycemic encephalopathy. [...]small-sized or medium-sized pupils can be found in brain death. [...]the size of the pupil cannot be the essential condition in brain death. Especially in conditions of ocular diseases or compound injury of head and face and trigeminal nerve or facial nerve diseases, which may influence the determination of corneal reflex, the results should be analyzed carefully. 3.