New guidelines on determining brain death released today offer the first updated recommendations in more than a decade for adult and pediatric patients.
The consensus practice guideline on brain death, also known as death by neurologic criteria , was developed by a panel of 20 experts from different specialties, institutions, and medical societies.
"The 2023 guidelines will be considered the standard of care in the US," lead author David M. Greer, MD, FAAN, FCCM, chair of neurology at Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center in Massachusetts, told."Each hospital in the US is responsible for its own policy for BD/DNC determination, and our hope is that they will quickly revise their policies in accordance with this new national standard.
In children, the guidelines recommend that clinicians must perform 2 clinical examinations and 2 apnea tests 12 hours apart. In adults, only 1 exam is required.The new guidelines replace adult practice guidance published by AAN in 2010 and guideline for infants and children released in 2011 by AAP, CNS, and SCCM, and for the first time combine brain death guidelines for adult and pediatric patients into one document.
He also noted that the section on credentialing and training of clinicians who perform BD/DNC evaluations recognizes advanced practice providers, the first time he recalls seeing these professionals included in brain death guidelines. The ACP suggests that"irreversibly" be replaced with"permanently" with regard to the cessation of circulatory and respiratory functions, but that"irreversible" be kept in the description of brain death.
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