Tuğhan UTKU, Süha BOZBAY, Seval ÜRKMEZ, Eren Fatma AKÇIL, Oktay DEMİRKIRAN, Yalım DİKMEN

Beyin ölümü için klinik tanı ve yardımcı testlerin tutarlılığı

DOI: 10.26650/cjm.2019.43.42Amaç: Beyin ölümü (BÖ), beyin ve beyin sapı işlevlerinin kalıcı yokluğunu ifade eder. Doğrulayıcı testler kullanılarak beyin sapı dışında bile tüm beyin bölgelerinde kan akışı olmadığı gösterilmelidir. BÖ tanısının uyumsuzluğunu klinik ve yardımcı testler (bilgisayarlı tomografik anjiyografi (BTA), manyetik rezonans görüntüleme anjiyografisi (MRIA), transkranial Doppler ultrasonografi (TKD-USG), elektroensefalografi (EEG)) ile değerlendirmeyi amaçladık. Yöntemler: 2012-2018 yılları arasında yoğun bakım ünitemize başvuran hastalar retrospektif olarak değerlendirildi. BÖ için 22 hasta değerlendirildi ve ayrıca 12 tanesinde, BÖ tanısında kesin tanı için yardımcı testler yapıldı. Tüm hastalar için demografik veriler, BÖ’nün nedenleri ve takipleri kaydedildi. Bulgular: On iki hastaya BÖ tanısı kondu. BÖ’ye neden olan nedenler intrakraniyal kanama, kardiyak arrest, intrakraniyal tümörler, pulmoner emboli, anevrizmal kanama, menenjit, subaraknoid kanama idi. Yaş ortalaması 40,86±15,62, ortalama APACHE II skoru 28,23±16,33 idi. Beyin ölümü 10 hastada klinik olarak teşhis edildi ve 12 hasta yardımcı testlerle değerlendirildi. Sonuç: Beyin ölümü klinik kriterlere göre teşhis edilebilir, ancak bir şekilde doğrulayıcı testler gerekli olabilir. BÖ’nün klinik olarak tanısı her zaman BTA ile tutarlı değildir ve tekrarlanması için prosedür gereklidir veya başka ileri teknikler kullanılmalıdır.Cite this article as: Utku T, Bozbay S, Ürkmez S, Akçıl EF, Demirkıran O, Dikmen Y. Assessing the consistency of clinical diagnosis and ancillary tests for brain death. Cerrahpasa Med J 2019; 43(1): 29-33.

Anahtar Kelimeler:

Beyin ölümü, yardımcı tanı testleri, bilgisayarlı tomografik anjiyografi

Assessing the Consistency of Clinical Diagnosis and Ancillary Tests For Brain Death

DOI: 10.26650/cjm.2019.43.42Objective: Brain death (BD) implies the permanent absence of cerebral and brainstem functions. It should be shown that there is no blood flow in all brain regions even besides the brainstem by using the confirmatory tests. We aimed to evaluate the incompatibility to diagnosis of BD by clinical and ancillary tests (computed tomographic angiography (CTA), magnetic resonance imaging angiography (MRIA), transcranial Doppler ultrasonography (TCD-USG), electroencephalography (EEG)).Methods: The patients admitted to our intensive care unit between 2012-2018 have been evaluated retrospectively. Twenty two patients who were assessed as BD, and additionally 12 of them had ancillary tests for BD for certain diagnosis investigated. Demographic data, causes of BD, and the follow ups were recorded for all patients.Results: Twelve patients were diagnosed as BD. The reasons leading to BD were intracranial hemorrhage, cardiac arrest, intracranial tumours, pulmonary embolism, aneurysmal hemorrhage, menengitis, subarachnoid hemorrhage. The mean age was 40.86±15.62 years, the mean APACHE II score was 28.23±16.33. Brain death was diagnosed by clinically in 10 patients, and 12 patients evaluated by ancillary tests. Conclusion: Brain death can be diagnosed based on clinical criteria, but in somehow confirmative tests may be necessary. Clinically diagnosing of BD is not always consistent with CTA, and procedure is needed to be repeated or other further techniques have to be used for confirmation.Cite this article as: Utku T, Bozbay S, Ürkmez S, Akçıl EF, Demirkıran O, Dikmen Y. Assessing the consistency of clinical diagnosis and ancillary tests for brain death. Cerrahpasa Med J 2019; 43(1): 29-33.

Keywords:

Brain death, ancillary tests, computed tomographic angiography,

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