?? Paper of the day
Prashant Nasa
Intensivist-Anaesthesiologist II Editor: Rational use of IV Fluids in Critically ll PROVE Network -Delphi Methodology II Fluid and Oxygen are Drugs
The 2023 American Academy of Neurology, American Academy of Pediatrics, Child Neurology Society, and Society of Critical Care Medicine Pediatric and Adult Brain Death/Death by Neurologic Criteria Determination Consensus Guidelines: What the Critical Care Team Needs to Know*
Published in Critical Care Medicine
Summary:
The article discusses the revised guidelines for brain death/death by neurologic criteria determination, which aim to provide an updated and consistent approach across all ages. It emphasizes the importance of familiarizing critical care teams with these guidelines, and outlines the prerequisite conditions, neurologic examination components, and ancillary testing considerations. The guidelines also stress the significance of maintaining clear and empathetic communication with families throughout the evaluation process.
?? takeaways:
1. The guidelines provide comprehensive and standardized protocols for brain death determination, highlighting the prerequisite conditions, observation periods, and rigorous neurologic examination components.
2. Clear and empathetic communication with families is emphasized to ensure understanding and support during the evaluation process, particularly in cases where families may have objections or difficulty understanding the concept of brain death.
3. The guidelines address the necessity of educating critical care clinicians and maintaining consistency in brain death determination protocols to foster public trust and ensure accurate evaluations in patients of all ages.
Counter arguments:
1. Critics may argue that the guidelines, despite aiming for standardization, could still introduce variability in practice, especially in situations where interpretation of specific components of the evaluation may differ among practitioners.
2. Some may question the practical implementation of certain protocols, such as the specified observation periods, and argue that they could be challenging to adhere to in real-world clinical settings.