To determine any discordance between first and second brain death examinations and investigate the quality of brain death determination in Canadian PICUs.
Multicenter retrospective chart review.
Four Canadian PICUs.
All deaths from 1999 to 2003 were screened. Patients included were 36 wks corrected gestation to 17 yrs old and had at least one brain death examination documented in the chart.
Medical records were reviewed to determine demographics, results of the brain death examinations, ancillary tests, and time intervals between injury event, fixed dilated pupils, first brain death examination, second brain death examination, and terminal event. Discordance between brain death examinations was defined as the medical conclusion documented in the chart as brain death followed by no brain death. Prespecified subgroups were age 1 yr old.
Some brain death diagnoses were not based on two examinations, and some did not include an apnea test. In patients who had two brain death examinations, discordant results were uncommon.
Comment In: Pediatr Crit Care Med. 2013 Jan;14(1):98-923295836