title: Modern Approach to Brain Death.
abstract: People die either when their heart and respiration stop or when their brain irreversibly stops functioning. This latter mode of death by neurologic criteria (also calledbrain death) emerged after the development of ventilators and intensive care units in the late 1950s and 1960s. Brain death is universally accepted as a modern entity, but the complex process for declaring a patient brain dead is not uniformly followed across country and state lines or even hospital policies, creating unacceptable variability and risks for falsely pronouncing a patient dead. If, however, the declaring physician has expertise and diligently follows the steps that have been published in guidelines, this risk is mitigated. In this article, the authors describe the steps for brain death declaration, discuss how to avoid pitfalls, and examine the modern controversies regarding this medical reality.
authors.affiliation: Division of Neurosciences Critical Care Services, Department of Neuro-Intensive Care Unit, Detroit, Michigan.
authors.forename: Panayiotis N
authors.initials: PN
authors.lastname: Varelas
authors.affiliation: Division of Neurocritical Care, Department of Neurology and Neurosurgery, NYU Langone Medical Center, New York, New York.
authors.forename: Ariane
authors.initials: A
authors.lastname: Lewis
mesh_terms: D001921:Brain; D001926:Brain Death; D006801:Humans; D007362:Intensive Care Units; D010820:Physicians