Pupillary diameter in brain death or clinical death: is it reliable?

Authors

  • D.A. Krishtafor State Institution “Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine”, Dnipro, Ukraine; Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro, Ukraine
  • A.A. Krishtafor State Institution “Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine”, Dnipro, Ukraine
  • D.M. Stanin State Institution “Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine”, Dnipro, Ukraine

DOI:

https://doi.org/10.22141/2224-0586.16.7-8.2020.223714

Keywords:

pupils, pupillary diameter, brain death

Abstract

Dilated pupils are traditionally considered one of the main signs of clinical death and brain death. Although in clinical practice even in biological death pupil size often remains medium. Pupil size evaluation is not included into modern CPR protocols and brain death diagnostics protocols.

References

Odendaal C.L. Cardiopulmonary-cerebral resuscitation. Sou­thern African Journal of Anaesthesia and Analgesia. 2010. Vol. 16. № 2. P. 45-60. doi: 10.1080/22201173.2010.10872665.

Westphal G.A., Garcia V.D., Lisboa de Souza R. et al. Guidelines for the assessment and acceptance of potential brain-dead organ donors. Rev. bras. ter. intensiva. 2016. Vol. 28. № 3. P. 220-255. doi: 10.5935/0103-507X.20160049.

Fogelholm R., Laru-Sompa R. Brain death and pinpoint pupils. J. Neurol. Neurosurg. Psychiatry. 1988. Vol. 51(7). P. 1002. doi: 10.1136/jnnp.51.7.1002.

Wexler J. Pupil size and irreversible coma. N. Engl. J. Med. 1971. Vol. 285(9). P. 526. doi: 10.1056/nejm197108262850922.

Chandra D.B., Agarwal T.N., Bihari V. Estimation of the time of death by papillary behaviour at different temperatures. Indian Journal of Ophtalmology. 1979. Vol. 27. № 4. P. 208-209.

Sagishima К., Kinoshita Y. Pupil diameter for confirmation of brain death in adult organ donors in Japan. Acute Med. Surg. 2017. Vol. 4(1). P. 19-24. doi: 10.1002/ams2.208.

Jung Е., You К.М., Lee S.J. et al. Continuous measurement of pupil size and light reflex during CPR in out-of-hospital cardiac arrest patients. Resuscitation. 2017. Vol. 118(Suppl. 1). P. e86-e87. doi: 10.1016/j.resuscitation.2017.08.208.

Gilston А. The eyes, the brain, and cardiac resuscitation. Resuscitation. 1994. Vol. 27. № 1. P. 77-79. doi: 10.1016/0300-9572(94)90026-4.

Hazinski M.F. Basic life support: provider manual. American Heart Association. Dallas, USA, 2016. 85 p.

Highlights of the 2015 American Heart Association Guidelines Update for CPR and ECC. Dallas, USA, 2015. 33 p.

Monsieursa K.G., Nolanc J.P., Bossaerte L.L. et al. Euro­pean Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation. 2015. Vol. 95. P. 1-80.

Наказ МОЗ України від 23.09.2013 р. № 821 «Про встановлення діагностичних критеріїв смерті мозку та процедури констатації моменту смерті людини» [Електронний ресурс]. 2013. Режим доступу: https://zakon.rada.gov.ua/laws/show/z1757-13.

Published

2021-04-05

Issue

Section

To Help the Practitioner