Circulatory Arrest, Brain Arrest and Death Determination

Circulatory Arrest, Brain Arrest and Death Determination

Technological advances, particularly in the capacity to support, replace or transplant failing organs, continue to challenge and refine our understanding of human death. Given the ability to reanimate organs before and after death, both inside and outside of the body, through reinstitution of oxygenated circulation, concepts related to death of organs (e.g. cardiac death) are no longer valid. T...

Thromboendarterectomy and circulatory arrest.

Thromboendarterectomy remains a high-risk procedure. The use of circulatory arrest as a technique to allow pulmonary artery visualization is associated with cerebral and organ damage secondary to the ischaemic insult. Application of techniques learned from thoracic aortic stenting and minimal invasive valvular surgery may mean that circulatory arrest becomes an uncommon accompaniment to thrombo...

Brain arrest, cardiac arrest and uncertainties in defining death.

In this issue, Lago et al. describe the existing realities of brain death in Latin America, as evaluated retrospectively in seven Brazilian pediatric intensive care units (PICU), and demonstrate some revealing observations. The investigators document substantial geographic variation in the diagnosis suggestive of differences in applying the clinical examination, rather than differences in case ...

Pulmonary circulatory arrest.

Deep hypothermic circulatory arrest.

Effective cerebral protection remains the principle concern during aortic arch surgery. Hypothermic circulatory arrest (HCA) is entrenched as the primary neuroprotection mechanism since the 70s, as it slows injury-inducing pathways by limiting cerebral metabolism. However, increases in HCA duration has been associated with poorer neurological outcomes, necessitating the adjunctive use of antegr...