Shemie Sam D, Hornby Laura, Baker Andrew, Teitelbaum Jeanne, Torrance Sylvia, Young Kimberly, Capron Alexander M, Bernat James L, Noel Luc
Canadian Blood Services and Division of Critical Care, Montreal Children's Hospital, McGill University Health Centre, 2300 Tupper Street room C-806, Montreal, QC, H3H 1P3, Canada,
Intensive Care Med. 2014 Jun;40(6):788-97. doi: 10.1007/s00134-014-3242-7. Epub 2014 Mar 25.
This report summarizes the results of the first phase in the development of international guidelines for death determination, focusing on the biology of death and the dying process, developed by an invitational forum of international content experts and representatives of a number of professional societies.
Precise terminology was developed in order to improve clarity in death discussion and debate. Critical events in the physiological sequences leading to cessation of neurological and/or circulatory function were constructed. It was agreed that death determination is primarily clinical and recommendations for preconditions, confounding factors, minimum clinical standards and additional testing were made. A single operational definition of human death was developed: 'the permanent loss of capacity for consciousness and all brainstem functions, as a consequence of permanent cessation of circulation or catastrophic brain injury'. In order to complete the project, in the next phase, a broader group of international stakeholders will develop clinical practice guidelines, based on comprehensive reviews and grading of the existing evidence.
本报告总结了死亡判定国际指南制定第一阶段的成果，该指南由国际内容专家和多个专业协会代表组成的邀请论坛制定，重点关注死亡生物学和濒死过程。
为提高死亡讨论和辩论的清晰度，制定了精确的术语。构建了导致神经和/或循环功能停止的生理序列中的关键事件。大家一致认为，死亡判定主要是临床性的，并针对前提条件、混杂因素、最低临床标准和额外检测提出了建议。制定了人类死亡的单一操作性定义：“由于循环永久性停止或灾难性脑损伤，意识和所有脑干功能永久性丧失”。为完成该项目，下一阶段将有更广泛的国际利益相关者群体，基于对现有证据的全面审查和分级，制定临床实践指南。
