Brain death determination and support of a potential organ donor are core topics in critical care. These topics aren't particularly uplifting or glamorous, so they often are overlooked. Consultants who don't spend a lot amount of time in the ICU may be uncomfortable with them. This makes it even more important that we have a firm grasp of these issues.
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In instances of cardiac arrest where TTM has been utilized, how long do you wait after rewarming to pursue formal brain death testing? 24 hours after rewarmed to 36.5 C? I know that we typically wait 72 hours from ROSC at a minimum for neuro prognostication post-arrest. Does pursing brain death testing fall into this? Ie, if a patient appears to meet criteria for brain death early post-arrest, is there any need to wait a full 72 hours to pursue formal testing? In my experience with cooling these patients, we end-up warming and waking around day 2-3 anyway, but I… Read more »