Cerebral Oximetry as an Auxiliary Diagnostic Tool in the Diagnosis of Brain Death

• Published in: Transplantation proceedings 2017-10, Vol.49 (8), p.1702-1707
• Main Authors: Tatli, O., Bekar, O., Imamoglu, M., Gonenc Cekic, O., Aygun, A., Eryigit, U., Karaca, Y., Sahin, A., Turkmen, S., Turedi, S.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Brain Death - diagnosis; Case-Control Studies; Cerebrovascular Circulation; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Oximetry - methods; Prospective Studies
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2017.06.027

To investigate the efficacy of cerebral oximetry (CO) as an auxiliary diagnostic tool in brain death (BD). This observational case-control study was performed on patients with suspected BD. Patients with diagnosis of BD confirmed by the brain death committee were enrolled as the BD group and other patients as the non-BD group. CO monitoring was performed at least 6 h, and cerebral tissue oxygen saturation (ScO2) parameters were compared. Mean ScO2 level in the BD group was lower than non-brain-dead patients: mean difference for right lobe = 6.48 (95% confidence interval [CI] 0.08–12.88) and for left lobe = 6.09 (95% CI −0.22–12.41). Maximum ScO2 values in the BD group were significantly lower than the non-BD group: mean difference for right lobe = 8.20 (95% CI 1.64–14.77) and for left lobe = 9.54 (95% CI 3.06–16.03). The area under the curve for right lobe maximum ScO2 was 0.69 (95% CI 0.55–0.81) and for left lobe was 0.72 (95% CI 0.58–0.84). Maximum ScO2 in brain-dead patients at CO monitoring is significantly low. However, this cannot be used to differentiate brain-dead and non-brain-dead patients. CO monitoring is therefore not an appropriate auxiliary diagnostic tool for confirming BD. •The spread of organ transplantation and the growing need for organs from cadaveric donors make it essential to diagnose BD faster, without harming the donor. This in turn is leading to a search for new corroboratory tests in the diagnosis of BD.•NIRS is a new, economical, and noninvasive imaging technique used to study brain functions.•This study was planned with the hypothesis that this noninvasive technique using NIRS technology can be an auxiliary tool in the diagnosis of BD.•According to our results, NIRS monitoring is insufficient for use as an auxiliary diagnostic tool in the definite diagnosis of BD or for identifying BD patients.