Brainstem death: A comprehensive review in Indian perspective

Abstract

With the advent of cardiopulmonary resuscitation techniques, the cardiopulmonary definition of death lost its significance in favor of brain death. Brain death is a permanent cessation of all functions of the brain in which though individual organs may function but lack of integrating function of the brain, lack of respiratory drive, consciousness, and cognition confirms to the definition that death is an irreversible cessation of functioning of the organism as a whole. In spite of medical and legal acceptance globally, the concept of brain death and brain-stem death is still unclear to many. Brain death is not promptly declared due to lack of awareness and doubts about the legal procedure of certification. Many brain dead patients are kept on life supporting systems needlessly. In this comprehensive review, an attempt has been made to highlight the history and concept of brain death and brain-stem death; the anatomical and physiological basis of brain-stem death, and criteria to diagnose brain-stem death in India.

Organ donation after brain death in India: A trained intensivist is the key to success

“…[ 7 ] Despite this, the brain death is not promptly declared in ICUs in India due to a lack of awareness and doubts about the legal procedure of certifying brain death. [ 8 ] This is seriously regarded among intensivists who play a key role in most other countries.…”

Management of potential organ donor: Indian Society of Critical Care Medicine: Position statement

“…[1914] Confirmatory tests such as EEG, cerebral angiography, transcranial Doppler, and radionuclide scan are not mandatory. As per the TOHA, the ancillary tests are not mentioned at all, hence its legal acceptability is challenging.…”

Somatic survival and organ donation among brain-dead patients in the state of Qatar

“…Regardless of the persisting function of other individual organs, whole brain death that results in permanent loss of brain function, loss of consciousness, cognition and respiratory drive is the hallmark of irreversible cessation of the function of the organism as a whole [2]. The survival of these patients post confirmation of brain death is termed as “somatic survival” and this is usually maintained with the help of breathing and or circulatory support.…”

“…The survival of these patients post confirmation of brain death is termed as “somatic survival” and this is usually maintained with the help of breathing and or circulatory support. Despite the wide-spread acceptance of brain death as death on clinical, ethical and legal grounds, the concept remains vague to many physicians as well as to the public [2]. A number of publications have questioned the use of brain death as clinical and legal death on ethical grounds [3–6].…”