Characteristics of brain death in children from Tolima, Colombia

Abstract

INTRODUCTION: brain death diagnosis is equivalent to individual death. Some of its causes can be preventable, always is a diagnosis of extreme importance for the rational use of resources in intensive care, the organs rescue, and the adequate advice to the families.
OBJECTIVE: to describe the main characteristics of some cases of brain death in children attended in the Federico Lleras Hospital in Ibague-Tolima, with emphasis on its etiology and associated dysfunctions.
METHODS: a descriptive study of cases with brain death diagnosed in the pediatric Intensive Care Unit in Federico Lleras Hospital-Ibague Colombia, between December 2003 and December 2005 was done. Patients under 15 years old with deep coma of diverse etiology were evaluated. A brain stem function tests were carried out and in those without response, one apnea test was performed. Patients with a positive apnea test were evaluated by a second specialist after a observation period of 12-24 hours, in concordance with the established parameters of the American Academy of Pediatrics Task Force and Colombian legal norms. Federico Lleras Hospital-Ibague Colombia, between December 2003 and December 2005 was done. Patients under 15 years old with deep coma of diverse etiology were evaluated. A brain stem function tests were carried out and in those without response, one apnea test was performed. Patients with a positive apnea test were evaluated by a second specialist after a observation period of 12-24 hours, in concordance with the established parameters of the American Academy of Pediatrics Task Force and Colombian legal norms.Data was collected in a pre-specified format.
RESULTS: 10 patients under 15 years old had brain death. Main causes were: central nervous system infection (50%), brain injuries (TCE- 30%), asphyxia by foreign body and convulsive state. The associated dysfunctions were: insipid diabetes, hyperglycemia, hypokalemia and hemodynamic instability. A patient was organs donor.
CONCLUSIONS: in the population attended in this unit of pediatric intensive care, central nervous system infection was the main cause of brain death followed by the brain injuries. These finds differs of studies carried out in other countries.