Brain Death Essay Assignment

The concept, definition, and understanding of death and brain death in the modern society are overlapping. Before the introduction of modern, sophisticated instruments, death has always been defined as the cessation of life which is as a result of stoppage of circulation of blood and vital functions of the body like respiration and pulsation. However, a new definition of death has now been developed based on the functions of these machines.Brain Death Essay Assignment The machines can maintain the respiration and heartbeat of a patient that is unresponsive to electrical activities of the brain. In modern medicine, this condition is called brain death; critical care physicians face challenges of how to care for a severely brain-damaged patient as all therapy is based on preservation and restoration of neuronal functions (Goila & Powar, 2009). If they are unsuccessful in achieving these, the patient becomes brain dead. The brain dies before any other organ of the body due to its sensitivity to injury and its inability to restore tissue after a severe injury. Irreversible death of the brain would, therefore, lead to the death of other organs because the brain is the command and control center of other body functions. This creates the definition of brain death as the “irreversible loss of all functions of the brain, including the brainstem” (Goila & Powar, 2009). Another definition based on artificial respiration defines brain death as “a state of cessation of cerebral function with preservation of cardiac activity and maintenance of somatic function by artificial means” (Longo et al., 2012. p. 2253).Brain Death Essay Assignment

The diagnosis of the brain death is based on several sets of criteria endorsed by the local medical community. Therefore, a patient cannot be confirmed brain dead until he/ she has met all of these criteria and they include: (1) widespread cortical destruction, reflected by deep coma and unresponsiveness to all forms of stimulation, (2) global brainstem damage that can be shown by absence of pupillary reaction to light, and loss of oculovestibular and corneal reflexes (3) destruction of the medulla, manifested by complete apnea (Longo et al., 2012).Brain Death Essay Assignment The causes of brain death are numerous as it was explained earlier that it is due to severe damage to the brain in which the doctors are unable to restore the neurological status of the patient. It is important that the physician understands the etiology of the brain damage because it would help in the process of certifying that a patient is brain dead. A few of the numerous causes of brain damage include hypertensive intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, hypoxic-ischemic brain insults and fulminant hepatic failure. The test for medullary destruction, which is manifested by apnea requires that PCO2 be high enough to stimulate respiration during spontaneous breathing. “Apnea testing can be done safely by use of diffusion oxygen prior to removal of a ventilator” (Longo et al., 2012. p. 2253). This can be achieved by preoxygenation with 100 percent oxygen; the oxygen is then sustained by administering through a tracheal cannula. The CO2 pressure increases between 2-3 mmHg during apnea, this pressure is then observed, at the end of the period of observation PCO2 has to increase to about 50-60 mmHg for the test to be valid. Apnea is, therefore, confirmed if no respiratory effort was observed in the presence of a high enough PCO2. Other tests that can be done are isoelectric EEG to confirm the total cerebral damage, Radionuclide brain scanning, and other features. Some period of observation usually between 6-24 hours is needed to see if the clinical signs of brain death hold. Therefore, it is necessary that the physician delay “clinical testing for at least 24 hours if a cardiac arrest has caused brain death or if the inciting disease is not known” (Longo et al., 2012. p. 2253).Brain Death Essay Assignment