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June 1968

The Isoelectric Electroencephalogram: Significance in Establishing Death in Patients Maintained on Mechanical Respirators

Author Affiliations

Iowa City

From the departments of psychiatry (Electroencephalography and Neurophysiology), surgery (Neurosurgery), and pathology (neuropathology), University of Iowa, Iowa City.

Arch Intern Med. 1968;121(6):511-517. doi:10.1001/archinte.1968.03640060025005

Experience with 25 isoelectric electroencephalograms obtained during the past ten years with the 25 "respirator brains" examined during the past three years is presented. Characteristic neuropathological features of the respirator brain consist of severe brain swelling, gray to hemorrhagic discoloration, marked softening, and both anoxic necrosis and autolysis of neurons. An isoelectric EEG, defined as complete loss of cortical electrical activity with maximal amplification, if sustained for an hour or more under appropriate clinical circumstances, is highly suggestive of cerebral death.