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神经学标准判定的死亡:病理生理学、定义、诊断标准和检测。

Death by neurologic criteria: pathophysiology, definition, diagnostic criteria and tests.

机构信息

Department of Anesthesia and Intensive Care, IRRCS for Oncology, University of Genoa, Genoa, Italy.

School of Medicine and Surgery, University of Milan-Bicocca, Monza, Monza-Brianza, Italy.

出版信息

Minerva Anestesiol. 2019 Jul;85(7):774-781. doi: 10.23736/S0375-9393.19.13338-X. Epub 2019 Mar 12.

Abstract

Death by neurologic criteria is an irreversible sequence of events culminating in permanent cessation of cerebral functions. In this context, there are no responses arising from the brain, no cranial nerve reflexes nor motor responses to pain stimuli, and no respiratory drive. The diagnosis of death by neurologic criteria implies that there is clinical evidence of the complete and irreversible cessation of brainstem and cerebral functions. The diagnosis, confirmation, and certification of death are core skills for medical practitioners. The aim of this review is to discuss the pathophysiology and definition of death by neurological criteria, describing the clinical assessment, and the use of ancillary tests for the diagnosis of brainstem death.

摘要

根据神经标准判定的死亡是一系列不可逆转的事件,最终导致大脑功能的永久性停止。在这种情况下,大脑没有反应,没有颅神经反射,也没有对疼痛刺激的运动反应,没有呼吸驱动力。根据神经标准判定的死亡意味着有临床证据表明脑干和大脑功能完全和不可逆转地停止。对医疗从业者来说,诊断、确认和认证死亡是核心技能。本综述的目的是讨论神经标准判定的死亡的病理生理学和定义,描述临床评估以及辅助测试在脑死亡诊断中的应用。

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