Question

Brain Death

Find a scholarly journal article relating to Brain Death. Post a 4-6 sentence summary of your article in your own words. Please include a reference as to where you find your information in APA reference

Answer 1

1) Ans)
       Brain death (BD) should be understood as the ultimate clinical expression of a brain catastrophe characterized by a complete and irreversible neurological stoppage, recognized by irreversible coma, absent brainstem reflexes, and apnea. The most common pattern is manifested by an elevation of intracranial pressure to a point beyond the mean arterial pressure, and hence cerebral perfusion pressure falls and, as a result, no net cerebral blood flow is present, in due course leading to permanent cytotoxic injury of the intracranial neuronal tissue. A second mechanism is an intrinsic injury affecting the nervous tissue at a cellular level which, if extensive and unremitting, can also lead to BD. We review here the methodology of diagnosing death, based on finding any of the signs of death. The irreversible loss of cardio-circulatory and respiratory functions can cause death only when ischemia and anoxia are prolonged enough to produce an irreversible destruction of the brain. The sign of such loss of brain functions, that is to say BD diagnosis, is fully reviewed.

Increased intracranial pressure (ICP) is considered the most important pathophysiological mechanism of BD leading to a complete cessation of intracranial blood flow. Upholding of oxygenation and hemodynamics by vasopressor drugs as well as mechanical ventilation can sustain somatic organs while the brain suffers an ongoing necrosis process. However, this is not the only pathophysiological mechanism of BD

Palmer and Bader studied a series of brain-dead patients by brain tissue oxygenation (PbtO₂) and described two pathophysiological patterns regarding cerebral blood flow (CBF).The most common pattern is manifested by an elevation of ICP to a point beyond the mean arterial pressure (MAP), and hence cerebral perfusion pressure (CPP) falls to zero and, as a result, no net CBF is present, in due course leading to permanent cytotoxic injury of the intracranial neuronal tissue,Andi leading to brain death.

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