Resumen:
The diagnosis of brain death and the determination of neurologic prognosis following cardiac arrest are important reasons for neurology consultation in the intensive care unit. In hospitals without access to neurology consultation, it may be challenging to address these important questions with high reliability in a timely manner. The American Academy of Neurology has established consensus criteria for diagnosis of brain death, which include (i) comatose state; (ii) presence of apnea; and (iii) absence of brainstem reflexes in the setting of a diagnosis of underlying brain injury compatible with brain death. It has recently been shown that virtual assessment of coma using standardized scales is feasible with good inter-rater reliability. The supervision of apnea testing and the neurologic examination of the brainstem by a remote neurologist are possible if conducted in conjunction with a well-trained and experienced bedside team. In this communication, we explore the essential clinical and legal framework that can support using virtual teleconsultations to address this complex topic.
Resumen divulgativo:
El diagnóstico de la muerte cerebral y la determinación de pronóstico neurológico después de un paro cardiaco son razones importantes para una consulta de neurología. En esta comunicación, se exploran los aspectos clínicos y el marco legal que permiten la utilización de teleconsultas para el diagnóstico de muerte cerebral.
Palabras Clave: telemedicine, telehealth, teleneurology, brain death diagnosis, legal/legislation
Índice de impacto JCR y cuartil WoS: 3,536 - Q2 (2020); 4,700 - Q1 (2022)
Referencia DOI:
https://doi.org/10.1089/tmj.2019.0033
Publicado en papel: Abril 2020.
Publicado on-line: Septiembre 2019.
Cita:
U.M. Girkar, R. Palacios, A. Gupta, L.H. Schwamm, P. Singla, H. May, J. Estrada, C.M. Whitney, M. Matiello, Teleneurology consultations for prognostication and brain death diagnosis. Telemedicine and e-Health. Vol. 26, nº. 4, pp. 482 - 486, Abril 2020. [Online: Septiembre 2019]
