ArticleDer Nervenarzt2023
[Diagnosis of brain death in Germany-Implementation of the guidelines of the German Medical Association].
Article in Der Nervenarzt, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Determination of brain death in potential donors on ECMO support : A retrospective analysis highlights the need for evidence-based recommendations.Die Anaesthesiologie · 2026Article
- Diagnosis of brain death and consecutive donor management under combined circulatory support with ECMELLA therapy.Frontiers in medicine · 2025Article
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3 authors.
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Abstract
backgroundThe 4th update of the guidelines of the German Medical Association on the diagnosis of irreversible loss of brain function (brain death, BD) has introduced important new regulations regarding the required qualification of the examiners, approved procedures for ancillary testing, and a clarification regarding the sequencing of diagnostic steps.
objectiveInvestigation of the implementation and practical effects on the diagnosis of brain death.
methodDescriptive evaluation of the routine documentation of the German Organ Procurement Organization, comparing the periods July 2011-June 2015 (3rd update) and July 2015-June 2019 (4th update).
resultsPatient numbers decreased from 6100 to 5403. The largest decrease affected hospitals without neurosurgery. Children were not affected. With the 4th update, clinical diagnostics were increasingly performed during on-call hours by external neurologists. Of the patients 83.8% now received ancillary tests compared to 80.1% previously. Computed tomography angiography (CTA), first introduced in the 4th update, was applied in 23.2% and established complete loss of cerebral circulation in 89.4%. The time between first documentation of the clinical signs of BD and certification of BD increased from 7.0 ± 12.7 h to 8.2 ± 14.2 h. The diagnosis was slightly less frequent with 95.3% compared to 96.6%.
conclusionThe updated standards were implemented in accordance with the guidelines. The demand for external consulting neurologists and neurosurgeons as well as the time required for BD assessment have increased. Negative effects on pediatric BD diagnostics were not apparent. CTA is widely and successfully used in adults as a new ancillary diagnostic procedure.
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