Discover and read the best of Twitter Threads about #braindeath
Most recents (6)
1/ You're finally settled in as an attending and you get a new patient.
They sound brain brain dead.
They clinically look brain dead.
Your team asks if they're brain dead.
Well this turned serious… a quick #tweetorial about 🧠 death
#NeuroTwitter #Neurocrit #MedTwitter
They sound brain brain dead.
They clinically look brain dead.
Your team asks if they're brain dead.
Well this turned serious… a quick #tweetorial about 🧠 death
#NeuroTwitter #Neurocrit #MedTwitter
2/ The transfer 📞 you got was a 28 yo with no other history. They were concerned about her being in status epilepticus.
You turn off all sedation. They're still unresponsive.
You turn off all sedation. They're still unresponsive.
3/ Clinically, they're intubated and have fixed and dilated 👀. No corneal or cough and not breathing over the vent. No motor response w/ painful stimuli 🤕
You scan their labs - ✅ no significant abnormalities You check their vitals - ✅ looks all good
What should we do next?
You scan their labs - ✅ no significant abnormalities You check their vitals - ✅ looks all good
What should we do next?
So this has been making the rounds. I realize it’s probably meant to be a thought experiment & deliberately provocative, but still, philosophical arguments should be rooted in at least some amount of reality.
I will now rage tweet about everything wrong w/ this concept. Enjoy🧵
I will now rage tweet about everything wrong w/ this concept. Enjoy🧵
Let’s start w/ the author’s premise: if we’re ok w/ #organdonation after brain death, then we should be ok w/ “whole body gestational donation” (WBGD).
Even putting aside the part about this sounding like a horrifying, dystopian baby farm, they’re not even remotely comparable.
Even putting aside the part about this sounding like a horrifying, dystopian baby farm, they’re not even remotely comparable.
Here’s why:
#Organdonation after brain death typically happens very quickly (a few days or less). This is not simply because we’re uncomfortable keeping someone’s organs alive longer; it’s because it’s incredibly challenging & often not possible, despite the authors assertions
#Organdonation after brain death typically happens very quickly (a few days or less). This is not simply because we’re uncomfortable keeping someone’s organs alive longer; it’s because it’s incredibly challenging & often not possible, despite the authors assertions
@ajboekestijn @g900ap Robert van der Noordaa..zelfbenoemde #trollenvanger en #factchecker bij @volkskrant #activisten kliek die..zie ik nu..geen factgecheckte #feiten van een wel deskundige ter zake verdraagt met zijn blijkbaar (te) grote ego en gevoelige tenen..
Je moet het maar kunnen..🤷♂️🤦♂️
Je moet het maar kunnen..🤷♂️🤦♂️
@ajboekestijn @g900ap @volkskrant >Geen idee waar Robert de deskundigheid, kennis en inzicht vandaan haalt om dit zo stellig te beoordelen als dat de wel objectieve en verifieerbare feiten zijn oordeel alleen al ontkrachten. Hoezo #factchecker? Hij #trolt nu zijn #complottheorie zelf als een volleerd #wappie.>
@ajboekestijn @g900ap @volkskrant >Wie wie heeft #vergiftigd en waarom is nog helemaal niet glashelder noch in enig rechtszaak vastgesteld. Weer volstrekt #wappie reactie en duiding van #RobertvanderNoordaa. Als ook feitelijk onjuiste conclusie wat Rusland van plan was of is. Dat is #propaganda, #complottheorie.>
There is so much confusion on what #braindeath is and what it is not (see or dailymemphian.com/subscriber/sec…) that I wanted to provide some education on this critically important matter. A 🧵 on its history and more #neurotwitter #medtwitter
1/
1/
Before mechanical ventilation, death was defined as the cessation of circulation and breathing, and even though it seemed straight forward, a true phobia in the 18th and 19th C was that of being buried alive. Hence #safetycoffins from where the term #savedbythebell is derived:
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In 1959, Mollaret and Goulon describe #comadepasee or "overcoma" where 23 people had no movement, no EEG activity, polyuria and required pressors, and would quickly die if pressors were stopped: pubmed.ncbi.nlm.nih.gov/14423403/ and was also described by Wertheimer/Jouvet the same year
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Here is the #PedsICU #BestOf2020 collection.
Jointly chosen by
@Dr_Hari_Krishna @sgdambrauskas and myself
Pubmed collection 40 articles: bit.ly/pedsicubestof2…
Infographic (clickable PDF) in English: bit.ly/bestof2020eng
Spanish: bit.ly/bestof2020esp
#PedsCICU #NeuroPICU
Jointly chosen by
@Dr_Hari_Krishna @sgdambrauskas and myself
Pubmed collection 40 articles: bit.ly/pedsicubestof2…
Infographic (clickable PDF) in English: bit.ly/bestof2020eng
Spanish: bit.ly/bestof2020esp
#PedsCICU #NeuroPICU
This will be a bilingual tweetorial in Spanish/English!
Infographics are available in both languages in Tweet #1
El hilo será en Español/Inglés. El resumen infográfico está disponible en los dos idiomas en el primer Tweet
Infographics are available in both languages in Tweet #1
El hilo será en Español/Inglés. El resumen infográfico está disponible en los dos idiomas en el primer Tweet
1/What are the outcomes that matter to children, to families and to #researchers/clinicians? @ericka_fink et al & @PostPICU_PALISI investigators identified COS using a delphi process. @CritCareMed bit.ly/381cfq8. Developmental and functional outcomes were important.
World 🌎 Brain Death Project – JAMA
We have WAY too much variation in use of DNC criteria for #braindeath.
Standardization must be improved. This publication is SO IMPORTANT & will reduce confusion as seen w Jahi McMath.
bit.ly/2Poa0Dr
#medtwitter #pulmcc
We have WAY too much variation in use of DNC criteria for #braindeath.
Standardization must be improved. This publication is SO IMPORTANT & will reduce confusion as seen w Jahi McMath.
bit.ly/2Poa0Dr
#medtwitter #pulmcc
AUDIO Highlights re: Brain 🧠 Death 📝
1. JAMA paper is a building block towards consensus & minimum standards.
2. International multidisciplinary effort can help others adopt criteria.
3. LISTEN👂to excellent interview w authors:
bit.ly/39RC2k4
1. JAMA paper is a building block towards consensus & minimum standards.
2. International multidisciplinary effort can help others adopt criteria.
3. LISTEN👂to excellent interview w authors:
bit.ly/39RC2k4
Apnea Test - this is a major research question addressed in the paper. What is the right PaCO2? There is arbitrariness around the criteria of >60, but it’s widely accepted and future work must study more.
