An appraisal of the criteria of cerebral death. A summary statement. A collaborative study
Based on the findings in a collaborative study of 503 comatose and apneic
patients, the establishment of cerebral death requires (1) that all
appropriate examinations and therapeutic procedures have been performed,
(2) that cerebral unresponsivity, apnea, dilated pupils, absent cephalic
reflexes, and electrocerebral silence be present for 30 minutes at least
six hours after the ictus, and (3) that if one of these standards is met
imprecisely or cannot be tested, a confirmatory test be made to demonstrate
the absence of cerebral blood flow. This would allow the diagnosis of a
dead brain to be made in patients with small amounts of sedative drugs in
the blood, In patients undergoing therapeutic procedures that make
examination of one or more of the cranial nerves impossible, and in
patients otherwise meeting the criteria whose pupils are small.
