Brain death in children: a retrospective review of patients at a paediatric intensive care unit

• Published in: Hong Kong medical journal = Xianggang yi xue za zhi 2020-04, Vol.26 (2), p.120-126
• Main Authors: Hon, K L, Tse, T T, Au, C C, Lin, W S, Leung, T C, Chow, T C, Li, C K, Cheung, H M, Qian, S Y, Leung, A K C
• Format: Article
• Language: English
• ISSN: 1024-2708
• DOI: 10.12809/hkmj198126

Among patients in paediatric intensive care units (PICUs), death is sometimes inevitable despite advances in treatment. Some PICU patients may have irreversible cessation of all brain function, which is considered as brain death (BD). This study investigated demographic and clinical differences between PICU patients with BD and those with cardiopulmonary death. All children who died in the PICU at a university-affiliated trauma centre between October 2002 and October 2018 were included in this retrospective study. Demographics and clinical characteristics were compared between patients with BD and patients with cardiopulmonary death. Of the 2784 patients admitted to the PICU during the study period, 127 died (4.6%). Of these 127 deaths, 22 (17.3%) were BD and 105 were cardiopulmonary death. Length of PICU stay was shorter for patients with cardiopulmonary death than for patients with BD (2 vs 8.5 days, P=0.0042). The most common mechanisms of injury in patients with BD were hypoxic-ischaemic injury (40.9%), central nervous system infection (18.2%), and traumatic brain injury (13.6%). The combined proportion of accident and trauma-related injury was greater in patients with BD than in patients with cardiopulmonary death (27.3% vs 3.8%, P