Age-specific characteristics of brain death in children.
Clinical and neuropathologic characteristics of 45 children who met criteria for brain death were analyzed. Children between 2 months and 1 year of age were compared with children older than 1 year and children older than 5 years. The observation period to fulfill brain death criteria was not different between the age groups. Deep tendon and spinal reflexes were preserved significantly less frequently in children younger than 1 year old. Diabetes insipidus and the necessity of inotropic support were significantly more frequent in children older than 5 years. Fifty-eight percent (26/45) of patients had no cerebral perfusion pressure before death. However, 18% (8/45) of patients never had a cerebral perfusion pressure below 40 mm Hg. No relationships could be shown between the clinical or physiologic factors and neuropathologic findings. We found no support for using different brain-death criteria for children between 2 months and 1 year of age.
Department of Anesthesiology/Critical Care Medicine, Johns Hopkins Hospital, Baltimore.
J C
JC
Fackler
J C
JC
Troncoso
F R
FR
Gioia
D000293:Adolescent; D000367:Age Factors; D001926:Brain Death; D002648:Child; D002675:Child, Preschool; D003919:Diabetes Insipidus; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009460:Neurologic Examination; D012021:Reflex, Abnormal