Brain Death Diagnosis and Management in the Pandemic: Expert Opinion of the Turkish Neurological Society Neurological Intensive Care Scientific Working Group

Tuğçe Mengi; Hadiye Şirin; Erdem Yaka; Atilla Özcan Özdemir; Ethem Murat Arsava; Mehmet Akif Topçuoğlu

doi:10.4274/tnd.2021.88785

Tuğçe Mengi¹, Hadiye Şirin², Erdem Yaka³, Atilla Özcan Özdemir⁴, Ethem Murat Arsava⁵, Mehmet Akif Topçuoğlu⁵

¹Nigde Training and Research Hospital, Clinic of Neurology, Intensive Care Unit, Nigde, Turkey
²Ege University Faculty of Medicine, Department of Neurology, Neurology Intensive Care Unit, Izmir, Turkey
³Dokuz Eylul University Faculty of Medicine, Department of Neurology, Neurology Intensive Care Unit, Izmir, Turkey
⁴Osmangazi University Faculty of Medicine, Department of Neurology, Neurology Intensive Care Unit, Eskisehir, Turkey
⁵Hacettepe University Faculty of Medicine, Department of Neurology, Neurology Intensive Care Unit, Ankara, Turkey

Keywords: Brain death, organ transplantation, CT angiography, aerosolization, apnea test

Abstract

In the pandemic year, the number of brain death declarations decreased by more than 50% compared with previous years. The timely diagnosis of brain death is critical in terms of rational use of intensive care facilities, as well as organ transplantation. Apnea testing should not be omitted in patients with COVID-19, and can be performed either with apneic oxygenation method or ventilator-based spontaneous modes when standard prerequisites are met. Complete compliance with personal protection measures and prevention of the environmental escape of the expiratory air via tube clamping or filtering is essential. Other declaration processes should be conducted in accordance with the 2014 guidelines of the Turkish Neurology Association.