Brain death and evoked potentials in pediatric patients

Ruiz-López, Marta; Azagra, A. Martínez de; Serrano, A.; Casado‐Flores, Juan

doi:10.1097/00003246-199902000-00051

Cited by 35 publications

(15 citation statements)

References 23 publications

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“…Amongst the 29 subjects who deceased, 26 had presented positive test (86,66%), data comparable to the obtained on similar studies carried through with children in Spain (90%) (3). Amongst the subjects who deceased, three (10%) had presented negative test, what implies false-negative tests, indicating sensitivity of 89% of the test.…”

Section: Discussionsupporting

confidence: 80%

“…On the other hand the EEG (electroencephalogram), examination that evaluates spontaneous cerebral electric activity of the cerebral hemispheres, is used for the determination BD. However the EEG suffers influences from potentially reversible conditions and some authors affirm to be a test of low specificity and that it should not be applied as the only examination for this intention (3).…”

Section: Discussionmentioning

confidence: 99%

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Potencial evocado auditivo de tronco encefálico como auxílio diagnóstico de morte encefálica

Jardim

Person

Rapoport

2008

Pró-Fono R. Atual. Cient.

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TEMA: Potencial Evocado Auditivo de Tronco Encefálico aplicado em morte encefálica. OBJETIVO: verificar a concordância entre o resultado do Potencial Evocado Auditivo de Tronco Encefálico e o desfecho do quadro clínico, em pacientes em coma Glasgow 3, por meio da análise do padrão de resposta elétrica do teste. MÉTODO: estudo tipo transversal realizado em 30 pacientes em coma Glasgow 3 submetidos ao Potencial Evocado Auditivo de Tronco Encefálico e acompanhados quanto ao desfecho clínico após o teste: recuperação ou óbito. O teste seria considerado positivo para morte encefálica ao registrar com reprodutibilidade ausência de todas as ondas ou presença de apenas a onda I, e considerado negativo na presença de duas ou mais ondas independentes de suas latências. RESULTADOS: entre os pacientes que apresentaram testes positivos para morte encefálica (86,66%), todos foram a óbito e o único paciente que se recuperou apresentou teste negativo indicando especificidade de 100%. Observou-se consistência interna dos dados, com coeficiente de correlação intraclasse de 0,562 por meio do Teste Alfa de Cronbach e concordância significativa entre o teste e o desfecho clínico por meio do Teste de Concordância de Kappa (K = 0,545; p = 0,015), com intervalo de confiança de 95%. CONCLUSÃO: para o presente estudo o Potencial Evocado Auditivo de Tronco encefálico demonstrou ser um teste altamente específico na predição de óbito em pacientes em coma Glasgow 3, e possibilitou auxiliar o diagnóstico de morte encefálica.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Potencial evocado auditivo de tronco encefálico como auxílio diagnóstico de morte encefálica

Jardim

Person

Rapoport

2008

Pró-Fono R. Atual. Cient.

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“…52,53 Diagnostic Yield of the EEG in Suspected Brain Dead Children Appendix 4 summarizes EEG data from 12 studies in 485 suspected brain dead children in all age groups. 34,[54][55][56][57][58][59][60][61][62][63][64][65] The data show that 76% of all children who were evaluated with EEG for brain death on the first EEG had ECS. Multiple EEGs increased the yield to 89%.…”

Section: Ancillary Studies (Recommendations 5a-e Table 1)mentioning

confidence: 99%

“…Data from the 12 studies cited in Appendices 4 and 5 were stratified by 3 age groups: (i) all children (n ϭ 149); (ii) newborns (Ͻ 1 month of age, n ϭ 30); and (iii) children age Ͼ 1 month to 18 years (n ϭ 119). 36,[54][55][56][58][59][60][61][62][63][64][65][66][67][68] The data in Appendices 4 and 5 show that the yield from the initial CBF studies was higher (86%) than from the initial EEG (76%) but no differences were present for any CBF study (89%) vs any EEG study (89%). In contrast the data in Appendix 6 for all children show that when both studies are initially performed, the diagnostic yield is the same (70% had ECS; and 70% showed absent CBF).…”

Section: Diagnostic Yield Of the Initial Eeg Versus Radionuclide Cbf mentioning

confidence: 99%

Guidelines for the Determination of Brain Death in Infants and Children: An Update of the 1987 Task Force Recommendations

Nakagawa¹,

Ashwal²,

Mathur³

et al. 2011

Pediatrics

183

120

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OBJECTIVE: To review and revise the 1987 pediatric brain death guidelines. METHODS: Relevant literature was reviewed. Recommendations were developed using the GRADE system. CONCLUSIONS AND RECOMMENDATIONS: (1) Determination of brain death in term newborns, infants and children is a clinical diagnosis based on the absence of neurologic function with a known irreversible cause of coma. Because of insufficient data in the literature, recommendations for preterm infants less than 37 weeks gestational age are not included in this guideline.

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“…Currently, the opinion that brain stem evoked potential records should be preferred over EEG to support the diagnosis of brain death is becoming predominant (12). Among the available methods, the best opinion about brain stem neuron activity is obtained by examination of responses to stimuli given to the neurons of the cochlear nerve in the brain stem.…”

Section: Observation Period and Laboratory Tests By Age Groupsmentioning

confidence: 99%

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Tatlı¹,

Ekici²

2011

tpa

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I In nv vi it te ed d A Au ut th ho or r S Su um mm ma ar ry yBrain death in pediatric patients is an new concept and becoming more important. The definition of brain death is the irreversible cessation of all functions of the entire brain including the brainstem. There are no definitive legal regulations in determining brain death in children as compared with adults. However, small children are more resistant to hypoxic brain damage and can show significant improvements despite the long-term coma. The purpose of this review and checklist for pediatric brain death is to provide a guide for appropriate diagnosis of brain death in children. (Turk Arch Ped 2011; 46: 94-8)

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Brain death and evoked potentials in pediatric patients

Cited by 35 publications

References 23 publications

Potencial evocado auditivo de tronco encefálico como auxílio diagnóstico de morte encefálica

Potencial evocado auditivo de tronco encefálico como auxílio diagnóstico de morte encefálica

Guidelines for the Determination of Brain Death in Infants and Children: An Update of the 1987 Task Force Recommendations

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