Auditory brain-stem response in determination of brain death
J. W. Hall 3rd, J. R. Mackey-Hargadine and E. E. Kim
A diagnosis of brain death requires evidence of irreversible destruction
(or dysfunction) of neurons in the brain stem and cerebrum. The physical
examination is not a valid index of brain integrity in patients who are
drug-intoxicated or receiving therapeutic paralyzing agents or high-dose
barbiturates. We evaluated the use of the auditory brain-stem response
(ABR) as an ancillary test in the determination of brain death. A total of
100 combined ABR and nuclear cerebral blood flow studies were completed at
bedside with 81 acute, severely brain-injured adults. The ABR and cerebral
blood flow outcomes were significantly correlated. We conclude that the ABR
is a clinically feasible and useful procedure in the determination of brain
death, especially in patients whose medical therapy compromises the
neurologic examination.
