In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss the clinical definition, diagnosis, and evaluation of brain death. They cover the physiological basis of brain death, common causes such as anoxic brain injury and intracranial hemorrhage, and potential mimics like Guillain-Barre syndrome and drug intoxications. The hosts outline the diagnostic features, emphasizing the importance of excluding confounders, performing a thorough neurological exam, and conducting an apnea test. They also discuss ancillary testing options like cerebral flow scans and EEGs, as well as the importance of communicating with the family and understanding the management of brain-dead patients, including considerations for organ donation. The episode concludes with a review of potential pitfalls in diagnosing brain death, such as overlooking mimics or misinterpreting spinal reflexes.
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