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September 1988

Age-Specific Characteristics of Brain Death in Children

Author Affiliations

From the Departments of Anesthesiology/Critical Care Medicine (Drs Fackler and Gioia) and Pathology (Dr Troncoso), The Johns Hopkins Hospital, Baltimore. Dr Fackler is now with The Children's Hospital, Boston.

Am J Dis Child. 1988;142(9):999-1003. doi:10.1001/archpedi.1988.02150090097034

• Clinical and neuropathologic characteristics of 45 children who met criteria for brain death were analyzed. Children between 2 months and 1 year of age were compared with children older than 1 year and children older than 5 years. The observation period to fulfill brain death criteria was not different between the age groups. Deep tendon and spinal reflexes were preserved significantly less frequently in children younger than 1 year old. Diabetes insipidus and the necessity of inotropic support were significantly more frequent in children older than 5 years. Fifty-eight percent (26/45) of patients had no cerebral perfusion pressure before death. However, 18% (8/45) of patients never had a cerebral perfusion pressure below 40 mm Hg. No relationships could be shown between the clinical or physiologic factors and neuropathologic findings. We found no support for using different brain-death criteria for children between 2 months and 1 year of age.

(AJDC 1988;142:999-1003)

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