Scripko Patricia D, Greer David M
Department of Neurology, Massachusetts General Hospital/Brigham and Women's Hospital, Boston, MA, USA.
Neurologist. 2011 Sep;17(5):237-40. doi: 10.1097/NRL.0b013e318224edfa.
Brain death criteria have been based on 3 cardinal features throughout history: coma, brainstem areflexia, and apnea, and thus have undergone little change. In 1995, the American Academy of Neurology (AAN) detailed these criteria in a step-by-step fashion that included meeting prerequisites, performing the clinical examination, performing ancillary testing, and documentation. Fifteen years later, many questions still remain regarding the diagnosis of brain death. The Quality Standards Subcommittee of the AAN sought to answer 5 of these outstanding questions. Ultimately, their data supported the utility of the 1995 criteria and warned against the use of new technologies before proper validation. This review briefly tells the story of brain death criteria, making mention of the steps outlined by the AAN in 1995 and discussing the recent evidence released by the Quality Standards Subcommittee in the new 2010 Practice Parameter Update.
昏迷、脑干反射消失和呼吸暂停，因此几乎没有变化。1995年，美国神经病学学会（AAN）逐步详细阐述了这些标准，包括满足前提条件、进行临床检查、进行辅助检查以及记录。十五年后，关于脑死亡的诊断仍有许多问题。AAN质量标准小组委员会试图回答其中五个突出问题。最终，他们的数据支持了1995年标准的实用性，并警告在未进行适当验证之前不要使用新技术。本综述简要讲述了脑死亡标准的历程，提及了AAN在1995年概述的步骤，并讨论了质量标准小组委员会在2010年新的实践参数更新中发布的最新证据。
