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.