Picard L, Braun M, Anxionnat R, Claise B, Ducrocq X, Pincemaille B, Hepner H
Service de Neuroradiologie Diagnostique et Thérapeutique, CHU Hôpital St Julien, Nancy.
Bull Acad Natl Med. 1995 Jan;179(1):27-37; discussion 37-40.
According to many ethical and humanitarian arguments, the diagnosis of "brain death" is more and more an emergency. The forensic criteria include abolition of consciousness, abolition of brain stem reflexes, abolition of spontaneous breathing joined to electrocerebral silence. However using EEG criteria of electrical silence may be unreliable because of technical artefacts or depressed electrical activity due to drug intoxication and hypothermia. Venous angiography was used in 125 cases: our experience proves reliability and efficiency of angiographic criteria for diagnosis of brain death. For organ transplant, it is better to be as fast as possible: transplanted organ will be better and it reduces the cost of a long useless intensive care. When it is necessary, we suggest to allow the choice between EEG and angiography.
基于诸多伦理和人道主义观点,“脑死亡”的诊断愈发成为一种紧急情况。法医判定标准包括意识丧失、脑干反射消失、自发呼吸停止且脑电图呈电静息状态。然而,由于技术伪差或药物中毒及体温过低导致的电活动抑制,使用脑电图电静息标准可能并不可靠。对125例患者使用了静脉血管造影术:我们的经验证明血管造影诊断标准对脑死亡诊断的可靠性和有效性。对于器官移植而言,越快越好:移植的器官质量会更佳,还能降低长期无效重症监护的成本。必要时,我们建议允许在脑电图和血管造影术之间进行选择。