Single or dual brain death exams: Tertiary hospital experience over 11.5 years

Abstract

Objective: To evaluate adoption of and reason for performing a single brain death exam (SBD) vs two (dual) brain death exams (DBD) and their impact on organ function and consent for organ donation. Background: Our hospital policy allows an optional SBD (with an apnea and a cerebral blood flow test) or a DBD (with an apnea test). Design/Methods: We evaluated our hospital\u27s BD registry between January 2006 and June 2017 regarding SBD or DBD. We also cross-matched our electronic medical records with the records of the local organ procurement organization. Results: Of 251 BD declarations, 115 (46%) were SBD and 136 (54%) DBD. During the 1 five years, 43% of all BD exams were SBD and during the second 57%. Patients with SBD were older (50.6±16.5 for SBD vs 46.5±17.1 years for DBD, p= 0.057), had a primary neurologic diagnosis (96% vs 47%, p\u3c 0.001) and were admitted to the Neuro- ICU (74% vs 27%, p\u3c 0.001). During the 2 exam, 76.7% patients were on equal or higher dose of pressors. SBD patients had lower K+, BUN, creatinine and heart st nd rate, but higher peak Na+ and apnea PaO2 (for all