Determination of brain death with use of color duplex scanning in the intensive care unit setting

G. W. Lemmon, R. W. Franz, N. Roy, M. C. McCarthy and J. B. Peoples
Department of Surgery, Wright State University School of Medicine, Dayton, Ohio, USA.

OBJECTIVE: To determine if color flow duplex scanning (CFDS) can be used for rapid confirmation of presumed brain death. DESIGN: Pilot cohort study comparison of CFDS with radionuclide cerebral scanning (RCS) as the criterion standard. SETTING: Community-based level I trauma center intensive care unit. PATIENTS: Twenty-four patients who satisfied criteria for presumed brain death. MAIN OUTCOME MEASURE: Confirmation of presumed brain death. RESULTS: CFDS correctly identified 16 of 24 patients as brain dead, confirmed by RCS. Eight patients with brain flow on RCS were also correctly identified by CFDS. Only two of 24 patients survived their severe injuries. CONCLUSIONS: CFDS provides a uniform, cost-effective diagnostic tool for rapid confirmation of clinical brain death with 100% accuracy. Its use should complement RCS, given its rapid interpretation, portability, and economical assessment of presumed brain death.