Evaluation of Patients Diagnosed With Brain Death in Pediatric Critical Care

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Abstract

Introduction

The frequency of brain death in pediatric intensive care units is unknown. Studies of brain death-organ donation in children are scarce and etiologies of brain death are different than adults. Our aim is to share patients in whom brain death occurs in our pediatric intensive care unit and discuss the shortcomings and failure in organ donation.

Methods

Medical reports of patients diagnosed with brain death in our pediatric intensive care unit between 1 January 2015 and 31 December 2016 have been retrospectively investigated. Data were screened according to gender, age, reason of hospitalization and mean duration of brain death evaluation. Ethics committee approval was obtained from Local Ethical Committee.

Results

Within two years in our pediatric intensive care unit, 83 of 806 (10.2%) patients died. Out of them, 14 (1.7%) were diagnosed with brain death. The mean duration of brain death evaluation was 2.14±1.16 days. Application reason to hospital were infection in 3 patients, asphyxia in 4 patients, malignancy in 4 patients, drowning in 2 and trauma in 1 patient. Mean age of patients with brain death diagnosis were 6.96±5.53 (min:0.6, max:16 year) year. Gender distribution was as following: 42.8% (6 patient) female and %57.2 (8 patient) male. Doppler USG was used in 11 patients (78.6%). None of the patients became organ donors because of medical unsuitability and family disagreement.

Conclusion

Due to the intensity of pediatric patients, trauma patients are rare in our pediatric intensive care unit. Most of the brain death cases result from asphyxia (mostly food aspiration), malignancy and drowning in water (fresh water drowning). In pediatric patients, the rates of organ donation are lower than for adults, thus increasing the number of brain deaths in pediatric intensive care units is even more important. We believe that awareness of brain death may increase if it is known that also other diseases than traumatic brain injury can cause brain death. With the increase of brain death diagnoses, we also believe that communication with patient relatives should be increased to encourage organ donation.

Keywords

Brain death, child, critical care, organ donation

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