<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction</bold>: Brain death is currently defined as the loss of full brain function including the brainstem. The diagnosis and its subsequent management in the pediatric population are still controversial. The aim of this study was to define the demographic characteristics, clinical features and outcomes of patients with brain death and determine the incidence of brain death, donation rates and occurrence of central diabetes insipidus accompanying brain death in children.<bold>Methods</bold>: This retrospective study was conducted at a twelve-bed tertiary-care combined medical and surgical pediatric intensive care unit of the Ondokuz Mayıs University Medical School, Samsun, Turkey. In 37 of 341 deaths (10.8%), a diagnosis of brain death was identified. The primary insult causing brain death was post-cardiorespiratory arrest in 8 (21.6%), head trauma in 8 (21.6%), and drowning in 4 (18.9%). In all patients, transcranial Doppler ultra-sound was utilised as an ancillary test and test was repeated until it was consistent with brain death.<bold>Results</bold>: In 33 (89%) patients, central diabetes insipidus was determined at or near the time brain death was confirmed. The four patients not diagnosed with CDI had acute renal failure, and renal replacement treatment was carried out. The consent rate for organ donation was 18.9%, and 16.7% of potential donors proceeded to actual donation.<bold>Conclusion</bold>: In the current study the consent rate for organ donation is relatively low compared to the rest of the world. The prevalence of central diabetes insipidus in this pedaitric brain death population is higher than reports in the literature, and acute renal failure accounted for the lack of central diabetes insipidus in four patients with brain death. Further studies are needed to explain normouria in brain-dead patients.</abstract>

Introduction: Brain death is currently defined as the loss of full brain function including the brainstem. The diagnosis and its subsequent management in the pediatric population are still controversial. The aim of this study was to define the demographic characteristics, clinical features and outcomes of patients with brain death and determine the incidence of brain death, donation rates and occurrence of central diabetes insipidus accompanying brain death in children.Methods: This retrospective study was conducted at a twelve-bed tertiary-care combined medical and surgical pediatric intensive care unit of the Ondokuz Mayıs University Medical School, Samsun, Turkey. In 37 of 341 deaths (10.8%), a diagnosis of brain death was identified. The primary insult causing brain death was post-cardiorespiratory arrest in 8 (21.6%), head trauma in 8 (21.6%), and drowning in 4 (18.9%). In all patients, transcranial Doppler ultra-sound was utilised as an ancillary test and test was repeated until it was consistent with brain death.Results: In 33 (89%) patients, central diabetes insipidus was determined at or near the time brain death was confirmed. The four patients not diagnosed with CDI had acute renal failure, and renal replacement treatment was carried out. The consent rate for organ donation was 18.9%, and 16.7% of potential donors proceeded to actual donation.Conclusion: In the current study the consent rate for organ donation is relatively low compared to the rest of the world. The prevalence of central diabetes insipidus in this pedaitric brain death population is higher than reports in the literature, and acute renal failure accounted for the lack of central diabetes insipidus in four patients with brain death. Further studies are needed to explain normouria in brain-dead patients.

Brain Death in Children: Incidence, Donation Rates, and the Occurrence of Central Diabetes Insipidus

Ondokuz Mayıs University School of Medicine

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Introduction: Brain death is currently defined as the loss of full brain function including the brainstem. The diagnosis and its subsequent management in the...

Brain Death in Children: Incidence, Donation Rates, and the Occurrence of Central Diabetes Insipidus

Published Online: Feb 09, 2018

Page range: 12 - 16

Received: Oct 31, 2017

Accepted: Jan 26, 2018

DOI: https://doi.org/10.2478/jccm-2018-0005

Keywords
brain death, children, diabetes insipidus, cerebral blood flow, organ donation

© 2018 Nazik Yener et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Brain Death in Children: Incidence, Donation Rates, and the Occurrence of Central Diabetes Insipidus

Published Online: Feb 09, 2018

Page range: 12 - 16

Received: Oct 31, 2017

Accepted: Jan 26, 2018

DOI: https://doi.org/10.2478/jccm-2018-0005

Keywordsbrain death, children, diabetes insipidus, cerebral blood flow, organ donation

© 2018 Nazik Yener et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
brain death, children, diabetes insipidus, cerebral blood flow, organ donation