Organ donation and procurementPersistence of intracranial diastolic flow in transcranial Doppler sonography exploration of patients in brain death
Section snippets
Materials and methods
Between January 2001 and December 2002, we reviewed the records of 11 patients with the clinical diagnosis of whole BD but with persistence of intracranial blood flow demonstrated on TDS. There were 9 men and 2 women at mean age of 46.6 years (range, 29–68 years). Six patients were treated and evaluated in the Intensive Care Unit (ICU) of the Hospital Clinic at Barcelona and 5 in the ICU of the Hospital Virgen del Rocio at Seville, Spain. The etiology of BD was craneoencephalic trauma (CET) in
Results
During the ICU stay all patients were treated and followed up by the intensivist in charge of the unit. To assess the evolution of neurological damage, all patients were continuously monitored with TDS to control CBF. After the clinical diagnosis of whole BD, TDS exploration was performed to evaluate 4 cerebral arteries (bilateral middle cerebral and vertebral arteries). All studies showed persistent telediastolic positive flow in at least 1 artery; the arterial registries showed an elevated
Discussion
Although clinical exploration is essential for the diagnosis of BD, when the concept of whole BD is used it is useful and advisable to perform an instrumental test to explore all supratentorial structures.2, 4 Commonly, CBF exploratory tests are suggested when the patient has been under treatment with CNS sedative drugs or presents metabolic disorders. Also, it is convenient to perform these tests to reduce the observation period between clinical exploration and to show the relatives to
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