In the article (1), a tool is presented that can inform doctors about a possible existence of brain death based on a symptom combination of lack of pupillary reaction and deep unconsciousness. Obviously It is a useful tool. This should force us to think about the situation of our ICUs.
Why doesn’t the physician responsible for the patient in the intensive care unit take 20 minutes a day to consider, without haste, the patient’s overall condition? This would also give the physician time to think about the neurological situation and to consider, without the e-mail generated by DETECT, which neurological outcomes can be expected for each patient. Irrespective of the question of organ donation, this would be information that is essential in discussions with relatives and when determining the goal of therapy.
The article also gives the reasons why such a tool is necessary in light of the failure of medical care (and it must be described as such, if the possibility of brain death is not considered even given a lack of pupillary reaction and deep unconsciousness): labor intensification, shift work, high caseload and a simultaneous staff shortage, economic pressure in the hospitals, in addition to medical focus on immediate healing.
Changing this would benefit not only those waiting for a donor organ but also the patients currently being treated in an intensive care unit. An additional 20 minutes of a physician’s working time per patient and day–not for more procedures, but for reassessing the therapy–would cost less than 30 Euros per day/per patient.
Footnotes
Conflict of interest statement:
The author declares that no conflict of interest exists.
References
- 1.Trabitzsch A, Pleul K, Barlinn K, et al. An automated electronic screening tool (DETECT) for the detection of potentially irreversible loss of brain function. Dtsch Arztebl Int. 2021;118:683–690. doi: 10.3238/arztebl.m2021.0307. [DOI] [PMC free article] [PubMed] [Google Scholar]