Chua Hoe Chin, Kwek Tong Kiat, Morihara Hirofumi, Gao Daiquan
Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore.
Department of Anaesthesiology, Intensive Care and Pain Medicine, Tan Tock Seng Hospital, Singapore.
Semin Neurol. 2015 Apr;35(2):152-61. doi: 10.1055/s-0035-1547539. Epub 2015 Apr 3.
Asia is the largest and most populous continent in the world with people from many diverse ethnic groups, religions and government systems. The authors surveyed 14 countries accounting for the majority of Asia's population and found that, although the concept of brain death is widely accepted, there is wide variability in the criteria for certification. Although most Asian countries have adopted the "whole-brain" concept of brain death, most countries with past colonial links to the United Kingdom follow the UK "brainstem" concept of brain death. Despite this difference, most countries require only neurologic testing of irreversible coma and absent brainstem reflexes as criteria for certification of brain death. Variability exists in the number of personnel required, qualifications of certifying doctors, need for repeat examination, minimum time interval between examinations, and requirement for and choice of confirmatory tests.
亚洲是世界上面积最大、人口最多的大陆,居住着许多不同种族、宗教和政治体制的人群。作者调查了占亚洲人口大多数的14个国家,发现尽管脑死亡的概念已被广泛接受,但认证标准却存在很大差异。虽然大多数亚洲国家采用了脑死亡的“全脑”概念,但大多数与英国有过殖民联系的国家遵循英国脑死亡的“脑干”概念。尽管存在这种差异,但大多数国家仅将不可逆昏迷的神经学检查和脑干反射消失作为脑死亡认证的标准。在所需人员数量、认证医生的资质、重复检查的必要性、检查之间的最短时间间隔以及确认性检查的要求和选择等方面存在差异。