Survival of Cardiac Function after Brain Death in Patients in Kuwait

Abstract

Background: Persistent cessation of all cerebral and brainstem function (brain death) is accepted in most countries as legal evidence of death. It is presumed that cardiac function will cease within a short time after brain death has occurred. In some countries, such as Kuwait, tradition and practice discourage application of the brain death criteria despite legal acceptance. Objective: The study was designed to assess the duration of persistence of cardiac function in patients after the diagnosis of brain death had been made on the basis of generally accepted criteria. Methods: We evaluated how long cardiac function persisted after brain function had ceased in 40 patients in Kuwait who were admitted to hospital and died during the 10-year period 1992–2001. Results: It was found that the mean persistence of cardiac function after brain death was 8.20 days and the median survival time was 6 days. Two thirds of the patients survived longer than a week, but none had cardiac function for longer than 30 days. Conclusion: The study confirms that brain death is not automatically followed immediately by cessation of all other body functions. It may be speculated therefore that whole-body homeostasis is not as intimately associated with brain function as has hitherto been thought.