Lewis Ariane, Kirschen Matthew P, Greer David
NYU Langone Medical Center (AL), NY; The Children's Hospital of Philadelphia (MPK), PA; Boston University School of Medicine and Boston Medical Center (DG), MA.
Neurol Clin Pract. 2023 Dec;13(6):e200189. doi: 10.1212/CPJ.0000000000200189. Epub 2023 Oct 11.
In collaboration with the American Academy of Pediatrics, Child Neurology Society, and Society for Critical Care Medicine, the American Academy of Neurology formulated an updated, evidence-informed consensus-based guideline for pediatric and adult brain death/death by neurologic criteria (BD/DNC) determination. In comparison with the prior guidelines, the revisions and additions in this guideline, which are summarized in this review, are intended to (1) ensure recommendations are conservative, yet practical, and emphasize circumstances in which BD/DNC determination should be delayed or deferred, so as to minimize the risk of a false-positive BD/DNC determination; and (2) provide guidance about aspects of BD/DNC determination that clinicians find challenging and/or controversial. We hope that clinicians throughout the United States will use this information to revise their hospital BD/DNC determination policies to conform to the standardized process for BD/DNC determination described in the new guideline, to ensure that every BD/DNC evaluation is consistent and accurate.
美国神经病学学会与美国儿科学会、儿童神经病学会以及危重症医学会合作，制定了一份更新的、基于证据和共识的关于儿童及成人大脑死亡/基于神经学标准判定死亡（BD/DNC）的指南。与先前的指南相比，本指南中的修订和补充内容（在本综述中进行了总结）旨在：（1）确保建议既保守又实用，并强调应延迟或推迟BD/DNC判定的情况，以尽量减少BD/DNC判定出现假阳性的风险；（2）针对临床医生认为具有挑战性和/或存在争议的BD/DNC判定方面提供指导。我们希望美国各地的临床医生利用这些信息来修订其医院的BD/DNC判定政策，使其符合新指南中描述的BD/DNC判定标准化流程，以确保每次BD/DNC评估都是一致且准确的。
