Department of Intensive Care, Erasmus MC University Medical Center, P. O. Box 2040, CA 3000 Rotterdam, The Netherlands.
Neurocrit Care. 2012 Oct;17(2):301-8. doi: 10.1007/s12028-011-9636-2.
As brain death is a difficult concept for the lay public to understand, we hypothesized that allowing relatives of the patient to be present during brain death determination would improve their understanding of this condition and would eventually lead to an increased consent rate for organ donation.
A prospective multicenter trial was conducted in five Dutch hospitals. Relatives were given the opportunity to be present during brain death testing. The family consent rate for organ donation was the primary endpoint examined, and the degree of the relatives' understanding of brain death was the secondary endpoint.
Between April 2010 and July 2011, we included the relatives of 8 patients in this study. The relatives witnessed brain death testing during this time. This sample size was too small to draw valid statistical conclusions. However, we have documented some noteworthy experiences of the relatives.
Although, the hypothesis behind this study had promise, we were unable to reach our predefined goal. The possible causes for this shortcoming included the rarity of patients with brain death, the common practice in the Netherlands of obtaining consent for organ donation before brain death testing and the uneasiness of the staff in the presence of the patients' relatives during brain death determination. Although, we cannot draw a conclusion from statistical evidence, we would recommend that relatives be given the opportunity to be present during brain death testing and, specifically, during the apnea test.
由于脑死亡对于普通公众来说是一个难以理解的概念，我们假设允许患者的亲属在脑死亡判定期间在场，将提高他们对这种情况的理解，并最终导致器官捐献的同意率增加。
在荷兰的五家医院进行了一项前瞻性多中心试验。亲属有机会在脑死亡测试期间在场。器官捐献的家庭同意率是主要的研究终点，亲属对脑死亡的理解程度是次要的研究终点。
在 2010 年 4 月至 2011 年 7 月期间，我们纳入了 8 名患者的亲属参与本研究。在此期间，亲属见证了脑死亡测试。由于样本量太小，无法得出有效的统计结论。然而，我们记录了一些值得注意的亲属的经历。
尽管该研究背后的假设很有前途，但我们未能达到预定的目标。造成这种缺陷的可能原因包括脑死亡患者的罕见性、荷兰在脑死亡测试前获得器官捐献同意的常见做法以及工作人员在脑死亡判定期间面对患者亲属时的不自在感。尽管我们无法从统计学证据中得出结论，但我们建议亲属有机会在脑死亡测试期间在场，特别是在呼吸暂停测试期间。
