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Reversible conditions that may mimic brain death
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Important to rule out these conditions in a patient before considering diagnosis of brain death:
Hypothermia: core temperatures in hypothermic range → rewarm before assessment
Treatable forms of shock → hypotension → profound cerebral hypoperfusion
Severe electrolyte or acid-base imbalance → unresponsiveness → manage critical values regardless of symptoms
Medications; illicit drugs; toxins → urine drug screen to identify → give antagonist if appropriate
Confirmatory tests for brain death:
Positive apnea test
2x isoelectric EEG 24 hrs apart
No cerebral blood flow (via cerebral angiography, transcranial Doppler, or MRI/MRA)
Hypothermia: core temperatures in hypothermic range → rewarm before assessment
Treatable forms of shock → hypotension → profound cerebral hypoperfusion
Severe electrolyte or acid-base imbalance → unresponsiveness → manage critical values regardless of symptoms
Medications; illicit drugs; toxins → urine drug screen to identify → give antagonist if appropriate
Confirmatory tests for brain death:
Positive apnea test
2x isoelectric EEG 24 hrs apart
No cerebral blood flow (via cerebral angiography, transcranial Doppler, or MRI/MRA)
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Reversible conditions that may mimic brain death
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