Brain death corresponds to the cessation of brain activity. Organ donation is possible.
The term “brain death” or “encephalic death” refers to the state of a person whose brain functions are stopped while heart functions are maintained. Generally, brain deaths follow a prolonged lack of oxygen, after traumatic brain injuries or a stroke for example. It is possible to remove organs from a brain dead patient if consent is proven.
What are the signs of brain death?
Certain signs can confirm the state of brain death: “The patient is in a very deep coma, he has no reaction, he has no reflexes and he is not breathing on his own,” explains Professor Sigismond Lasocki, anesthesiologist-resuscitator.
Is it possible to wake up brain dead?
No. A brain dead patient is considered deceased. Brain death is irreversible. “If we are dead, we are dead. What is possible, however, is to be in a state of apparent death (particularly in the case of hypothermia…). To establish the diagnosis of brain death, it is necessary that the patient does not have any anesthesia medication circulating and is not hypothermic” indicates the specialist.
“The context is important because this situation is only possible in a patient who is in hospital, in intensive care. We cannot say of a person who died in the street that they are brain dead” warns Professor Sigismond Lasocki. “We examine the patient, we check that he has no reactivity, no persistent archaic reflex, that he is not breathing on his own, we even take a blood test after the apnea test to check if he There is carbon dioxide in the blood because it accumulates when we do not breathe. All of these elements allow us to make the diagnosis of brain death. From that moment on, we can. clinically state that the patient is dead. Their heart continues to beat because it is a muscle that has its own “battery” it continues to beat as long as it has enough oxygen to function, that is. as long as the patient is connected to a machine to make him breathe”, explains the resuscitator.
Brain scan shows there is no blood circulating in the brain anymore
Organ donation is possible when the patient is on a ventilator
As soon as this clinical diagnosis has been established, the resuscitator can unplug the machine and issue the death certificate. But, as long as the patient is on a respirator, the blood is oxygenated and the organs are perfused: we can then take an organ sample. “However, this requires proving brain death, either by doing an electroencephalogram with at least 30 minutes of recording, twice, four hours apart, or by performing a brain angioscan which proves to us that there is no brain death. more blood circulation in the brain. At this time, we discuss with the relatives to find out if the patient wanted to donate his organs or not.“, nuance Professor Sigismond Lasocki.
What is the deadline for disconnecting in the event of brain death?
“The patient is dead, so continuing to keep him breathing makes no sense. Once death is pronounced, there is no reason to wait to disconnect the patient. We can leave it until the family comes but it’s symbolic.” underlines the specialist.
Thanks to Professor Sigismond Lasocki, anesthesiologist-resuscitator and head of the ASUR center (Anesthesia, SAMU, Emergency Resuscitation) at Angers University Hospital
