Persistencia de actividad eléctrica cerebral tras el diagnóstico clínico de muerte encefálicaincidencia, impacto y análisis comparativo del electroencefalograma frente a la angiografía por tomografía computarizada

Resumen

Objective: To determine the incidence, causes and evolution of patients with persistence of electrocerebral activity (PECA) or cerebral blood flow (PCBF) despite a complete neurological clinical examination (CNCE) of brain death (BD), and to analyze its impact on organ donation. Methods: adult patients with a diagnosis of BD from 2000-2017. Clinical, electroencephalographic and radiological data were reviewed. We calculated the BD interval (BDI) as the time between the CNCE and the confirmatory ancillary test of BD. Results: in 15 of 408 patients (3.7%), vs 21 of 53 (39.6%), we observed PECA and PCBF, respectively (p <0.001). Infratentorial etiology was associated with both situations (p <0.0001). There was an increase in family refusals for organ donation associated with a BDI > 6 hours (p = 0.02). Conclusions: the PECA after a clinical diagnosis of BD is infrequent and associated with infratentorial brain injury. BDI >6 h reduced the consents for organ donation.