determination of physiological dead space quesion

Proponents of the idea of neurologic criteria to diagnose brain death argue that the body is more than the sum of its parts, and that death is equated to loss of the whole person. In order to promote a broad understanding by lay persons, scientists, and legal powers, most experts advocate for use of the term BD/DNC. In fact, one of the salient remaining debates in the field involves the terminology of brain death, sometimes also referred to as “whole brain death”, or “brainstem death”. įirst, what does the term “brain death” truly mean? This is perhaps best understood by exploring the evolution and controversy of the idea. In 1987, the American Academy of Pediatrics task force on brain death in children published guidelines for the pediatric population, which was updated in 2011. In 1980, the Uniform Determination of Death Act established a legal basis for a neurologic determination of death in the U.S., and adult guidelines were put forth in the 1995 (and revised 2010) American Academy of Neurology (AAN) guidelines on the determination of BD/DNC.

In 1968, a group of Harvard faculty proposed the first clinical definition as the Harvard Brain Death Criteria, which consisted of clinical and EEG criteria. Neurologists began to postulate that neurologic function was equally or more vital than cardiopulmonary function, and began a process to define death neurologically, independent of other essential organ functions. In 1959, the concept of brain death/death by neurologic criteria (BD/DNC) was first theorized as “le coma dépassé”, by Mollaret and Goulon, who described an apneic, comatose patient without brainstem reflexes or electroencephalographic (EEG) activity.

In the years that followed, the development of advanced live support measures including cardiopulmonary resuscitation (CPR) and positive pressure ventilation (PPV) brought this interdependence and the traditional definition of death into question. It naturally followed that cessation of brain function occurred after the loss of respiration and circulation, and indeed loss of brain activity was considered a critical component of death. Preceding the 1950s, the concept of death revolved around cessation of cardiorespiratory function.

Determination of physiological dead space quesion