Evidence map›Paper›PMID 34931292›Full record

ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2022

Clinical evaluation and ancillary testing for the diagnosis of death by neurologic criteria: a cross-sectional survey of Canadian intensivists.

Michaël Chassé, Joel Neves Briard, Michael Yu, Livia P Carvalho, Shane W English, Frédérick D'Aragon, François Lauzier, Alexis F Turgeon, Sonny Dhanani, Lauralyn McIntyre and 6 more

Abstract read
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In one paragraph

Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Article
  4. Infratentorial brain injury and death by neurologic criteria in Canada: a narrative review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023
    Review
  5. Review
  6. Rationale for revisions to the definition of death and criteria for its determination in Canada.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Michaël ChasséCentre de recherche du Centre hospitalier de l'Université de Montréal, 900 rue St-Denis, Montreal, QC, H2X 3H8, Canada. michael.chasse@umontreal.ca.ORCID http://orcid.org/0000-0001-7075-1924
Joel Neves BriardCentre de recherche du Centre hospitalier de l'Université de Montréal, 900 rue St-Denis, Montreal, QC, H2X 3H8, Canada.
Michael YuCentre de recherche du Centre hospitalier de l'Université de Montréal, 900 rue St-Denis, Montreal, QC, H2X 3H8, Canada.
Livia P CarvalhoCentre de recherche du Centre hospitalier de l'Université de Montréal, 900 rue St-Denis, Montreal, QC, H2X 3H8, Canada.
Shane W EnglishCritical Care, University of Ottawa, Ottawa, ON, Canada.
Frédérick D'AragonCanadian Donation and Transplant Research Program, Ottawa, ON, Canada.
François LauzierCHU de Québec Research Center, Université Laval, Quebec City, QC, Canada.
Alexis F TurgeonCHU de Québec Research Center, Université Laval, Quebec City, QC, Canada.
Sonny DhananiCanadian Donation and Transplant Research Program, Ottawa, ON, Canada.
Lauralyn McIntyreCritical Care, University of Ottawa, Ottawa, ON, Canada.
Sam D ShemieDonation and Transplantation, Canadian Blood Services, Ottawa, ON, Canada.
Gregory KnollCanadian Donation and Transplant Research Program, Ottawa, ON, Canada.
Dean A FergussonCritical Care, University of Ottawa, Ottawa, ON, Canada.
Samantha J AnthonyCanadian Donation and Transplant Research Program, Ottawa, ON, Canada.
Matthew J WeissCanadian Donation and Transplant Research Program, Ottawa, ON, Canada.
Canadian Critical Care Trials Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTrust in the deceased organ donation process relies on the expectation that the diagnosis of death by neurologic criteria (DNC) is accurate and reliable. The objective of this study was to assess the perceptions and approaches to DNC diagnosis among Canadian intensivists.

methodsWe conducted a self-administered, online, cross-sectional survey of Canadian intensivists. Our sampling frame included all intensivists practicing in Canadian institutions. Results are reported using descriptive statistics.

resultsAmong 550 identified intensivists, 249 (45%) completed the survey. Respondents indicated they would be comfortable diagnosing DNC based on clinical criteria alone in cases where there is movement in response to stimulation (119/248; 48%); inability to evaluate upper/lower extremity responses (84/249; 34%); spontaneous peripheral movement (76/249; 31%); inability to evaluate both oculocephalic and oculo-caloric reflexes (40/249; 16%); presence of high cervical spinal cord injury (40/249; 16%); and within 24 hr of hypoxemic-ischemic brain injury (38/247; 15%). Most respondents agreed that an ancillary test should always be conducted when a complete clinical evaluation is impossible (225/241; 93%); when there is possibility of a residual sedative effect (216/242; 89%); when the mechanism for brain injury is unclear (172/241; 71%); and if isolated brainstem injury is suspected (142/242; 59%). Sixty-six percent (158/241) believed that ancillary tests are sensitive and 55% (132/241) that they are specific for DNC. Respondents considered the following ancillary tests useful for DNC: four-vessel conventional angiography (211/241; 88%), nuclear imaging (179/240; 75%), computed tomography (CT) angiography (156/240; 65%), and CT perfusion (134/240; 56%).

conclusionThere is variability in perceptions and approaches to DNC diagnosis among Canadian intensivists, and some practices are inconsistent with national recommendations.

Indexed as

Brain DeathTissue and Organ ProcurementCanadaCross-Sectional StudiesHumansancillary testbrain deathclinical evaluationclinical examinationdeath by neurologic criterianeurologic determination of deathsurvey

Identifiers

PMID34931292

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.