Interdisciplinary approach in post-cardiac arrest anoxic brain injury with unconfirmed brain death
Year: 2025
Type: article
Study design: Case Report
Abstract: Severe anoxic brain injury after cardiac arrest can produce a clinical picture suggestive of brain death (BD). However, when ancillary testing, such as radionuclide cerebral perfusion scans (RCPS), shows preserved cerebral perfusion, the diagnosis of brain death cannot be confirmed, complicating end-of-life decision-making. We present a case of a post-cardiac arrest patient with profound neurological injury and absent brainstem reflexes. Although the clinical findings resembled brain death, two RCPS showed preserved cerebral perfusion, ruling out a formal brain death diagnosis. As a result, withdrawal of life-sustaining therapies was not permitted under existing protocols, despite a poor prognosis. How should clinicians navigate end-of-life care in cases of anoxic brain injury with unconfirmed brain death? This case underscores that when severe anoxic brain injury with unconfirmed brain death occurs, the focus must shift beyond diagnostic algorithms toward a broader, human-centered approach. Interdisciplinary collaboration—including the involvement of the palliative care team—ensures that in cases of unconfirmed brain death, care remains guided by integrity, empathy, and the best interests of the patient and family. An interdisciplinary ICU team—including intensivists, neurologists, and the palliative care team—worked together to engage the patient’s family. This collaboration enabled clear communication, support through complex decisions, and a focus on compassionate and goal-concordant care. In post-cardiac arrest patients with anoxic brain injury with unconfirmed brain death, interdisciplinary teamwork is vital. Palliative care team involvement ensures ethically sound, patient-centered care in this complex situation.
Source: BMC Palliative Care
Institution: Capital Health
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,990
OpenAlex ID: W4414985602