Brain Death

Your purchase of the print version of Brain Death includes access to videos available via Oxford Medicine Online. By activating your unique access code, you can discover these videos, and use them for teaching and training purposes. Brain Death provides a practical, comprehensive, clinical resource for practitioners seeing patients with acute catastrophic neurologic disorders evolving to brain death and all its ramifications. The clinical diagnosis of brain death has tremendous implications: its main purpose is to bring closure, but it often results in organ and tissue transplantation questions which need to be addressed. This third edition introduces new research in the intensive care unit, newly unearthed historical data on important US-UK differences, a thorough discussion of US guidelines and how it is used in hospital practices, and compares guidelines used elsewhere in the world. In this incisive work, the many complexities of diagnosis and management of brain death are examined but it also illuminates cultural beliefs and bioethical problems, highlights the nature of conferences with family members, and captures several organ procurement issues. The book also includes 30 commonly asked practice problems to resolve diagnostic uncertainties and conflicts along with 12 video clips to assist in neurological evaluation. Brain Death is a treatise by the leading expert on brain death, Eelco F.M. Wijdicks. This book is a work of primary source research and includes work from recent publications by the author. It is an invaluable resource for neurologists, neurointensivists, neurosurgeons, anesthesiologists, trauma surgeons, neuroscience and intensive care nursing staff, transplantation surgeons, and organ procurement organizations.

Table of Contents:
Preface to the Third Edition Preface to the Second Edition Acknowledgments Chapter 1: History of Brain Death A New Comatose State Appears Defining Neurologic Criteria for Death in Us Chapter 2: Neurology of Brain Death The Pathology of Brain Death Clinical Examination in Adults The Clinical Determination of Brain Death in Children Documentation Teaching Brain Death Determination Errors and Alleged Recoveries Legal Definitions and Obligations Chapter 3: International Criteria of Brain Death Guidelines in the United Kingdom Guidelines World Wide Consensus for a Uniform World Wide Standard Chapter 4: Beliefs About Brain Death Religious Beliefs Cultural Views Religious Conflict Resolution Chapter 5: Critics and Brain Death The Uncertainty of Death Emerging Controversies Critique Chapter 6: Procurement After Brain Death Transitioning to Organ Donation Organ Procurement Organizations Organ Donation Requests Preparation for Determining Organ Suitability Donation Protocols Medical Management of the Organ Donor Chapter 7: Clinical Problems in Brain Death and Organ Donation 1. The Qualifications of the Examiner 2. Clinical Mimics 3. Acid-Base Disturbances 4. Electrolyte Abnormalities 5. Acute Intoxications and Overdose 6. Reliability of Ancillary Tests 7. Ancillary Tests and Confounders 8. Primary Brainstem Lesion 9. Uncertainty About Interpreting Spinal Reflexes 10. Ventilator Autocycling 11. Chronic CO2 Retention and Apnea Test 12. Terminating the Apnea Test 13. Breathing during the Apnea Test 14. Pneumothorax during the Apnea Test 15. Cardiopulmonary Resuscitation 16. Extracorporeal Membrane Oxygenation 17. Anencephaly 18. Shaken Baby Syndrome 19. Maternal Brain Death 20. Legal Challenges 21. Family Opposition 22. Family Presence during Testing 23. Sperm and Oocyte Retrieval 24. Organ Donation Management 25. Organ Donation and the Hemodynamically Unstable Donor 26. DCD Pitfalls 27. DCD in the Operating Room 28. Organ Donation in Prisoners 29. Organ Donation, Consent and Costs 30. Organ Donation and Directing the Gift Index

About the Author :
Eelco F.M. Wijdicks is Professor of Neurology, Mayo Clinic College of Medicine, Chair of the Division of Critical Care Neurology, and Consultant, Neurological Neurosurgical Intensive Care Unit, Saint Marys Hospital, Mayo Clinic

Review :
"Dr. Wijdicks' latest edition of his book on Brain Death is outstandingly authoritative. As the undisputed world authority on the subject, Dr. Wijdicks provides a comprehensive and relatively unbiased understanding of brain death, from its important conception and legalization to modern approaches, worldwide practice and ethical and legal issues that surround the entity. It is packed with useful tables, as well as helpful video clips that illustrate key findings and educate the reader. In an era where there seems to be increasing controversy about this subject, the book is timely and definitive, and should serve as a strong reference for both clinicians and the lay public alike." -David M. Greer, MD, MA, Professor of Neurology, Yale University School of Medicine, New Haven, CT "One of the multiple requirements for successful organ donation and transplantation is a robust and comprehensive understanding and application of brain death principles. Once again Eelco Wijdicks contributes greatly to the medical community with this definitive resource on this subject."--Susan Gunderson, Chief Executive Officer, LifeSource, Minneapolis, MN "Dr. Wijdicks is the world's leading authority on brain death. He continues to advance the knowledge base while honoring the historical context of the brain death concept. This is the definitive resource for all aspects of brain death determination and its intricate relationship to organ donation. If you know very little about brain death, you should read this book. If you think you know a lot about brain death, you should still read this book. The section on clinical problems and common clinical questions is an extremely useful practical guide to managing common complexities of clinical practices in this field."--Sam D. Shemie, MD, Division of Critical Care Medicine, Montreal Children's Hospital, McGill University Health Centre & Research Institute, Montreal, Canada Praise from the Second Edition "In this well-written, thorough yet concise second edition book by Eelco Wijdicks, we are given both a historical and scientific tour of the process of declaring someone dead by neurologic criteria...I found the final part of the book where 25 clinical problems in brain death are explored to be some of the most insightful and clinically useful material I have read on the subject matter...Dr. Wijdicks is a well-known and respected expert on the process of death by neurologic criteria. He has been at the forefront of defining its criteria and in educating the world's neuroscience and critical care physicians on its process. Any physician who meets their institutional criteria to pronounce death in this way should have this book readily available." -- Critical Care Medicine "Eelco Wijdicks is the preeminent expert on brain death in the world. In this second edition of Brain Death, Dr. Wijdicks again provides a definitive and comprehensive text on the subject, while still being concise and practical enough to be of use to clinicans in daily practice. This book is mandatory for the libraries of actively practicing neurosurgeons, neurologists, and neurointensivists." -- Jonathan A. Friedman, MD, Regional Chair of Surgery, Bryan - College Station Campus, Associate Professor, Departments of Surgery, Neuroscience and Experimental Therapeutics, Texas A&M Health Science Center College of Medicine, Director, The Texas Brain and Spine Institute, Bryan, TX "Dr. Wijdicks is one of the most accomplished experts in neurological critical care...[and] among his major contributions are his observations and clinical experiments regarding the examination of the patient with a severely damaged nervous system. [He] has catalogued his enormous personal experience in the second edition of his work, Brain Death. He has successfully distilled the literature into six chapters: The History of Brain Death, The Neurology of Brain Death, Beliefs about Brain Death, Critics and Brain Death, Procurement after Brain Death and Clinical Problems in Brain Death. There is no one in the world more personally qualified to deal with this complex and sensitive subject. The job of reviewing the broad swath of data and opinion about this subject is a daunting one but Dr. Wijdicks has proved he is up to the task in his new second edition of Brain Death." --Martin Samuels, MD, Chairman, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School