The underlying pathologic lesion should be understood;
There should be no pharmacologic, metabolic, or hormonal influence;
Pupillary, corneal, occulo-cephalic, vestibule-occular, and gag reflexes should be absent;
No pain response to stimulation in the distribution of the fifth cranial nerve; and
A re-breathing test with 100% oxygen should be delivery to maintain satisfactory oxygenation, while ventilation is switched off. The rise in arterial pCO2 should not stimulate respiration.
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