Somatic death and Asystole after brain death diagnosis; duration of circulatory survival in the intensive care unit (S42.005)

Objective: We are looking into our data to evaluate predictors of somatic survival. Background: It is well agreed that the clinical diagnosis of brain death equates actual death. Previous data suggested a strong correlation of somatic survival and age of the patient. Design/Methods: All medical records for patients admitted to the international extended care center in Saudi Arabia were reviewed from the period of July 2016 to July 2017. We included all patients with the diagnosis of brain death in accordance to the international guideline for the neurological determination of death. There was no age limit for inclusion. We calculated the number of days these patients stayed in the ICU from the time of confirmed brain death until they are pronounced asystolic. Results: 20 patients fulfilled the clinical criteria of brain death. 9 of which were female. The youngest patient was 13 years old and the oldest 92 with a median age of 68. 65% (13/20) had stroke as the primary admission diagnosis, 9 patients of which were ischemic and the other 4 were intracerebral hemorrhage. 4/20 where maintained on support for about 2 days “the shortest duration” and the rest had a range between 6 and 206 days translating into 6.8 months of somatic survival. The 206 days survivor was 69 years old and one of the 2 days survivors were 16 years of age. There was no significant correlation to age or primary diagnosis and all other possible variables that may affect somatic survival. The most common complications were hypernatremia, acute kidney failure, and infections and usually they lead to rapid deterioration and somatic death. Conclusions: Patients who are brain dead may still maintain other body functions ‘if supported’ and stay long in the intensive care unit. We are reporting one of the longest somatic survivals in the literature after the diagnosis of brain death. There was no clear correlation to age as reported previously and neither to any other potential confounder. Disclosure: Dr. Ayoub has nothing to disclose. Dr. Bushnag has nothing to disclose. Dr. Abdelaal has nothing to disclose. Dr. Ghodeif has nothing to disclose.