background trauma constitutes a major public health problem in our country and contributes significantly to unacceptably high morbidity and mortality. objectives this study aimed to evaluate the epidemiology of trauma in dead patients referred to shahid rajaee trauma hospital, shiraz, iran. patients and methods in a cross-sectional study, all patients with trauma admitted to our center were enr...

409 VOLUME 48__MAY 17, 2011 I read with interest the article by Kaushik, et al. [1]. The authors have covered the topic in all the aspects where an act of commission is required by the doctors. However, I would like know whether an informed consent is necessary when withdrawing life support in a brain dead patient. Is it appropriate that the family is explained the irreversibility of the situat...

STUDY OBJECTIVE To determine the accuracy of the online Social Security Death Index (SSDI) for determining death outcomes. METHODS We selected 30 patients who were determined to be dead and 90 patients thought to be alive after an ED visit as determined by a web-based searched of the SSDI. For those thought to be dead we requested death certificates. We then had a research coordinator blinded...

CASE-REPORT A 45 year old male working as a labourer in the agricultural sector was brought to the emergency room with complaints of difficulty in opening the eye-lids, dysphagia, dysphonia, dyspnea, and progressive weakness in all four limbs, after awakening from sleep. At presentation, patient had no spontaneous respiratory efforts and was deeply cyanosed. Endotracheal intubation was performe...

To the Editor: In a recent issue of Critical Care Medicine, with interest we read the article by Dhanani et al (1), concerning vital signs after circulatory arrest following withdrawal of lifesustaining therapy. The article has timely given the persistent controversy regarding criteria of death in circulatory death organ donors. How many minutes after circulatory arrest can we consider the pati...

The "dead donor rule" is increasingly under attack for several reasons. First, there has long been disagreement about whether there is a correct or coherent definition of "death." Second, it has long been clear that the concept and ascertainment of "brain death" is medically flawed. Third, the requirement stands in the way of improving organ supply by prohibiting organ removal from patients who...

The aim of the study was to determine the specificity and sensitivity of Transcranial Doppler Sonography (TCD) as a confirmatory test for diagnosis of brain death and to assess the possibility of adding this test to the protocol for diagnosis of brain death in ICU. TCD examination was done in 20 patients (group I) with brain death confirmed either by clinical assessment and EEG (17 patients) or...

BACKGROUND Cardiac dysfunction after brain death has been documented, but its mechanisms remain unclear. Myocardial ischemia has been suggested as a possible cause. The aim of the present study was to investigate the existence of an imbalance between myocardial oxygen delivery and demand as a possible cause of myocardial dysfunction in brain-dead pigs. METHODS AND RESULTS Interstitial myocard...