title: Brain death induced by cerebral haemorrhage - a new porcine model evaluated by CT angiography.
abstract: BACKGROUND
  Brain death and complications to brain death affects the function of organs in the potential donor. Previous animal models of brain death have not been able to fully elucidate the mechanisms behind this organ dysfunction, and none of the available animal models mimic the most common insult prior to brain death: intracerebral haemorrhage. The objective of this study was to develop a large animal model of brain death based on a controlled intracerebral haemorrhage and verified by computerised tomographic angiography (CTA).
  
  
  METHODS
  Twenty pigs (range: 26.6-31.2 kg) were randomised to brain death or control. Brain death was induced by infusion of blood through a stereotaxically placed needle in the internal capsule. Brain death was confirmed by the measured intracranial pressure (ICP), lack of corneal and pupillary light reflexes, and atropine test. CTA was performed 120-180 min after brain death. The pigs were observed for 8 h after brain death.
  
  
  RESULTS
  Brain death was declared when the ICP exceeded mean arterial pressure after a median of 36 min (range: 28-51 min). Significant increases in heart rate, and mean arterial pressure (MAP) were followed by a steep decrease. With fluid therapy, the animals demonstrated haemodynamic stability. Reflexes disappeared, and atropine did not induce an increase in heart rate in the brain dead animals. CTA confirmed loss of cerebral circulation.
  
  
  CONCLUSIONS
  This study offers a standardised, clinically relevant porcine model of brain death induced by a haemorrhagic attack. Brain death was verified by the disappearance of corneal and pupil reflex, atropine test, and CTA.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Aarhus University Hospital, Denmark. c.hvas@ki.au.dk
authors.forename: C L
authors.initials: CL
authors.lastname: Hvas
authors.forename: T K
authors.initials: TK
authors.lastname: Nielsen
authors.forename: A
authors.initials: A
authors.lastname: Barklin
authors.forename: J C H
authors.initials: JC
authors.lastname: Sørensen
authors.forename: M
authors.initials: M
authors.lastname: Pedersen
authors.forename: G
authors.initials: G
authors.lastname: Andersen
authors.forename: E
authors.initials: E
authors.lastname: Tønnesen
mesh_terms: D000818:Animals; D062186:Arterial Pressure / Q000187:drug effects; D001285:Atropine; D001784:Blood Gas Analysis; D001926:Brain Death / Q000503:physiopathology*; D002302:Cardiac Output / Q000502:physiology; D002533:Cerebral Angiography / Q000379:methods*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging*; D004195:Disease Models, Animal; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006728:Hormones / Q000097:blood; D007427:Intracranial Pressure / Q000187:drug effects; D019344:Lactic Acid / Q000097:blood; D018727:Muscarinic Antagonists; D010101:Oxygen Consumption / Q000502:physiology; D012018:Reflex / Q000502:physiology; D012151:Resuscitation; D013552:Swine; D014057:Tomography, X-Ray Computed; D014882:Water-Electrolyte Balance / Q000502:physiology
chemical_list: D006728:Hormones; D018727:Muscarinic Antagonists; D019344:Lactic Acid; D001285:Atropine