Brain death and postmortem organ donation: report of a questionnaire from the CENTER-TBI study

van Veen, Ernest; van der Jagt, Mathieu; Cnossen, Maryse C.; Maas, Andrew I. R.; de Beaufort, Inez D.; Menon, David K.; Citerio, Giuseppe; Stocchetti, Nino; Rietdijk, Wim J. R.; van Dijck, Jeroen T. J. M.; Kompanje, Erwin J. O.

doi:10.1186/s13054-018-2241-4

Critical Care

Table 4 Practices around the hands-off time after circulatory arrest

From: Brain death and postmortem organ donation: report of a questionnaire from the CENTER-TBI study

	Region
Answer	Sample total (N = 64)	Baltic States (N = 5)	Eastern Europe (N = 6)	Israel (N = 2)	Northern Europe (N = 9)	Southern Europe (N = 12)	United Kingdom (N = 8)	Western Europe (N = 22)
After withdrawal of mechanical ventilation and after circulatory arrest, when exactly do you declare the patient dead in case of a circulatory death organ donor?
Directly after circulatory arrest determined after a “flatliner-ECG” on the monitor	16	40	0	50	11	8	0	23
After 1-min “flatliner-ECG” indicating circulatory arrest	5	0	0	50	0	8	0	5
After 2-min “flatliner-ECG”	2	0	0	0	0	0	0	5
After 5-min “flatliner-ECG”	23	20	33	0	11	17	50	23
After 10-min “flatliner-ECG”	5	20	17	0	0	0	0	5
After loss of pulsatile arterial curve on the invasive arterial blood pressure tracing	6	20	17	0	0	0	0	9
After 20-min “flatliner-ECG”^a	11	0	0	0	0	58	0	0
Not done in our hospital/country^a	19	0	17	0	78	0	0	18
Other, please specify^b	14	0	17	0	0	8	50	14
	Sample total (N = 66)	Baltic States (N = 5)	Eastern Europe (N = 6)	Israel (N = 2)	Northern Europe (N = 9)	Southern Europe (N = 12)	United Kingdom (N = 8)	Western Europe (N = 24)
After withdrawal of mechanical ventilation and after circulatory arrest, after how many minutes circulatory arrest do you declare the patient dead in cases not suitable as organ donor?
Directly after circulatory arrest determined after a “flatliner-ECG” on the monitor	32	40	17	100	11	17	13	50
After 1-min “flatliner-ECG” indicating circulatory arrest	5	0	0	0	0	0	0	13
After 2-min “flatliner-ECG”	0	0	0	0	0	0	0	0
After 5-min “flatliner-ECG”	23	20	17	0	22	25	38	21
After 10-min “flatliner-ECG”	6	20	33	0	0		0	0
After loss of pulsatile arterial curve on the invasive arterial blood pressure tracing	6	20	33	0	11	0	0	0
After 20-min “flatliner-ECG”^a	9	0	0	0	0	50	0	0
Not done in our hospital/country^a	8	0	0	0	33	0	0	8
Other, please specify^c	12	0	0	0	22	0	50	8

Data presented as percentage
EEG electroencephalography
^aAdditional categorical responses, while free text responses were sufficiently similar
^bSpecifications filled in under “other”: “two minutes after loss of pulsatile arterial curve on the invasive arterial blood pressure tracing”; “after 3 min”; “No carotid pulses and apnoea”; “absence central pulse for 5 mins confirmed by observation for further 5 mins”; “National guidance 5 mins mechanical asystole”; “apnea test positivity”; “according to the Dutch law on organ donation”; “Protokollbogen zur Feststellung des irreversiblen Hirnfunktionsausfalls”; “at the beginning of the commission observation (6 h before)”
^cSpecifications filled in under “other”: “Control 10 min later”; “After clinical death diagnosis: listen to heart sound, examination of pupils”; “At decision of the physician”; “No carotid pulses and apnoea”; “absence central pulse for 5 mins confirmed by observation for further 5 mins”; “apnea test positivity”; “according to the Dutch law on organ donation”; “Protokollbogen zur Feststellung des irreversiblen Hirnfunktionsausfalls”; “at the beginning of the commission observation (6 h before)”

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ISSN: 1364-8535

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