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首页> 外文期刊>Annals of Intensive Care >A survey of American neurologists about brain death: understanding the conceptual basis and diagnostic tests for brain death
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A survey of American neurologists about brain death: understanding the conceptual basis and diagnostic tests for brain death

机译：美国神经科医生对脑死亡的调查：了解脑死亡的概念基础和诊断测试

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Background Neurologists often diagnose brain death (BD) and explain BD to families in the intensive care unit. This study was designed to determine whether neurologists agree with the standard concept of death (irreversible loss of integrative unity of the organism) and understand the state of the brain when BD is diagnosed. Methods A previously validated survey was mailed to a random sample of 500 board-certified neurologists in the United States. Main outcomes were: responses indicating the concept of death that BD fulfills and the empirical state of the brain that would rule out BD. Results After the second mailing, 218 (44%) surveys were returned. Few (n = 52, 27%; 95% confidence interval (CI), 21%, 34%) responded that BD is death because the organism has lost integrative unity. The most common justification was a higher brain concept (n = 93, 48%; 95% CI, 41%, 55%), suggesting that irreversible loss of consciousness is death. Contrary to the recent President's Council on Bioethics, few (n = 22, 12%; 95% CI, 8%, 17%) responded that the irreversible lack of vital work of an organism is a concept of death that the BD criterion may satisfy. Many responded that certain brain functions remaining are not compatible with a diagnosis of BD, including EEG activity, evoked potential activity, and hypothalamic neuroendocrine function. Many also responded that brain blood flow and lack of brainstem destruction are not compatible with a diagnosis of BD. Conclusions American neurologists do not have a consistent rationale for accepting BD as death, nor a clear understanding of diagnostic tests for BD.
机译：背景神经科医生经常诊断出脑死亡（BD），并向重症监护室的家庭解释BD。这项研究旨在确定神经科医生是否同意死亡的标准概念（有机体整合性不可逆转的丧失）并了解诊断BD时大脑的状态。方法将先前经过验证的调查邮寄给美国500名经董事会认证的神经科医生的随机样本。主要结果是：表明BD满足死亡概念的反应以及排除BD的大脑经验状态。结果第二次发送邮件后，返回了218个（44％）调查。很少有人（n = 52，27％; 95％置信区间（CI），21％，34％）回答说BD是死亡，因为该生物丧失了整合统一性。最常见的理由是较高的大脑概念（n = 93，48％; 95％CI，41％，55％），表明不可逆的意识丧失是死亡。与最近的总统生物伦理委员会相反，很少有人（n = 22，12％; 95％CI，8％，17％）回答说，生物不可逆转地缺乏重要工作是BD标准可以满足的死亡概念。 。许多人回答说，剩余的某些脑功能与BD的诊断不兼容，包括脑电图活动，诱发的潜在活动和下丘脑神经内分泌功能。许多人还回答说脑血流不足和脑干破坏不足与BD的诊断不符。结论美国神经科医生对将BD视为死亡没有一致的理由，也没有对BD诊断测试的清楚理解。

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