Department of Pediatrics, Neonatal Intensive Care Unit, Pediatric Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain.
J Perinatol. 2012 Jun;32(6):473-5. doi: 10.1038/jp.2011.147.
We want to illustrate the difficulty of establishing a brain death diagnosis in newborn children and how an easy and useful tool, the transcranial Doppler ultrasonography, can leave an unexpected result that complicates the process despite the rest of the diagnostic tests. We describe a 36-week gestation newborn male who was diagnosed of brain death after asphyxiated and offered for donation. After initial stabilization at admission, we established brain death diagnosis by checking and meeting every criterion. The donation process was complicated because of persistent blood flow on transcranial Doppler ultrasonography. Transcranial Doppler ultrasonography is a very useful method to assess cerebral blood flow. However, caution and individualization are needed when interpreting this complementary exam, especially in highly conflictive situations like brain death diagnosis.
我们想要说明在新生儿中确立脑死亡诊断的困难，以及即使其他诊断测试没有问题，一种简单而有用的工具——经颅多普勒超声检查——也可能得出意想不到的结果，从而使诊断过程变得复杂。我们描述了一名 36 周妊娠的男性新生儿，因窒息被诊断为脑死亡并被提议捐献。在入院时的初步稳定后，我们通过检查和满足每个标准来确定脑死亡诊断。由于经颅多普勒超声检查中持续存在血流，捐献过程变得复杂。经颅多普勒超声检查是评估脑血流的非常有用的方法。然而，在解释这种补充检查时需要谨慎和个体化，尤其是在脑死亡诊断等高度冲突的情况下。
