What is Brain Stem Death? Dr. Aparna Patil.

 

What is Brain stem death?

This is the most important topic in Organ Donation Awareness.Brain dead patient can give life to at least 7 to 9 individuals.Brain stem death or brain death or neurological death is not well understood by many people. They tend to confuse it with coma

There is difference between comatose patient & brain dead individual.

 Comatose patient.....

• is not dead.

• can regain consciousness.

• may respond to deep stimuli.

• has respiration on his / her own.

Brain death means death.

• Patient is dead.

• no chance of regaining consciousness.

• no response to deep stimuli.

• Respiration is aided by ventilator.

"Brain death is an irreversible death."

How does the BS death occur?

Brain stem is associated with important functions of respiration and consciousness.

If any form of head injury or major stroke or brain tumour

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Leads to brain edema or swelling

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Skull is hard bone...does not allow brain to expand.

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Medicines tried to reduce swelling, but if no success.

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Pressure on brain vessels starts rising...a stage comes when  this pressure exceeds the pressure in the blood vessels of beating heart.

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Heart can't force oxygenated blood  into the brain.

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No blood supply to brain

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Brain cells die & undergo lysis ie. liquification

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That is why, brain death is irreversible. Once BS die, person stops breathing

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No oxygen supply to heart.

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All vital organs are devoid of oxygen....their function stop.

So ,how it is possible for brain dead patient to donate vital organs?

Friends, patient is  on ventilator during his treatment, to help him breath.  The working of heart is independent of brain. It has its own pacemaker... SA node. As long as heart is getting oxygen (from ventilator ) , it will continue to beat...for some period of time...maybe for few hours or sometimes even for a week and then die. As the blood supply to the organs can be maintained , during this period, the organs can be retrieved after relative's consent. This death can occur only in intensive care unit i.e. ICU.

How is brain death declared?

Brain death is declared by brain death committee.Many tests like... are carried out at the interval of 6 hours.

Brain stem death is an irreversible death. No one has ever woken up from brain death. BD  has nothing to do with mercy killing; organs are never taken at the cost of donors life. First aim of the doctors is to treat the patient upto their  best level... using all skill, expertise but once patient is declared brain dead, patient can't be revived... but we can help other patients to gain new life.

In this situation, a question arises...what the family should do?  

Should the family wait till heart stops beating & all organs die or they should consider organ donation & save others life?

Emotionally, it is very difficult  for the family who have lost their loved one & every family should do what they feel is right....there is absolutely no force or compulsion on the family to donate organs!

This is why Organ donation awareness is extremely important. It should not be a new concept but each & every Indian citizen should be aware of it.

We have already lost our beloved one but just imagine , our dear one is going to live in this world in the form of organs...giving life to someone else......

Friends,

© Dr. Aparna Viraj Patil 

MD ( Obstetrics and Gynaecology)

Organ donation awareness.

Mumbai.