Reversing Brain Death: Far
From gene editing to human head transplantation, the limits of medical science are being pushed further than ever. And now, researchers have turned their attention to another extraordinary mission: reversing brain death.
Though it sounds similar to the makings of fiction, scientists have received approval for the first ever trial that aims to restore neuronal activity in humans who have been declared brain dead.
The proof-of-concept study which forms a part of the Reanima Project is the brainchild of two life sciences companies: Bioquark, Inc., based in the United States, and Revita Life Sciences, based in India.
Due to begin later this year, the trial will recruit 20 individuals who have suffered brain death as a result of traumatic brain injury , but whose bodies are biologically alive as a result of cardiopulmonary and trophic support a model referred to as a living cadaver.
To participate in the trial, each subject must be aged between 15 and 65 years, be unwilling for organ donation, and have written consent from a legally acceptable representative.
Researchers including Bioquark CEO Ira Pastor will test a variety of techniques that previous studies have demonstrated to possess neuroregenerative properties, and these will be combined with devices that have been shown to stimulate the central nervous system of coma patients.
Tests To Confirm Brain Death
Although rare, a few things can make it appear as though someone is brain dead.
These include drug overdoses and severe hypothermia, where body temperature drops below 32C.
A number of tests are carried out to check for brain death, such as shining a torch into both eyes to see if they react to the light.
Establishing The Absence Of Respiratory Function
The final step in establishing brain death is the apnea test. Apnea is the medical term for the suspension of breathing and is used in this instance to ascertain whether the suspension is permanent.
To perform an apnea test, the doctor would take the following steps:
If there is no respiratory movement and the PaCO2 has increased to over 60meaning that there has been no exchange of oxygen and carbon dioxide in the lungsthe person will be declared brain-dead.
If on the other hand, a respiratory movement is observed, then the person cannot be considered brain-dead. Further investigations would then be performed to identify what, if anything, can be done to reverse the condition.
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What Does Brain Death Mean
Brain death is a legal definition of death. It is the complete stopping of all brain function and cannot be reversed. It means that, because of extreme and serious trauma or injury to the brain, the body’s blood supply to the brain is blocked, and the brain dies. Brain death is death. It is permanent.
Things To Look For When Considering A Setting To Care For Your Loved One:
Here are some things to look for when choosing a place for care:
- Your family members current treatment team has received good feedback about the programs quality of care when they have referred others there.
- The staff make you feel comfortable. They are available to talk about your concerns, and they answer your questions.
- The program has a multidisciplinary treatment team that, at a minimum, includes a rehabilitation physician, nurse, speech pathologist, physical therapist, occupational therapist, psychologist, and social worker.
- The treatment team meets together to identify treatment goals and review progress.
- The program and treatment staff have worked with the same kinds of problems that your family member has.
- The facility knows about the specific care your loved one needs and can meet those needs. You can help to make sure that a detailed nursing care plan is created.
- The program includes case management to help plan for the next level of care, whether its moving to a rehabilitation program, an LTACH, a SNF, or home.
- The program provides education and training for future caregivers.
- The program has a systematic approach to measure progress in all patients.
- The program is guided by recommendations for rehab programs from the American Congress of Rehabilitation Medicine and the NIDILRRs Traumatic Brain Injury Model System.
- The program receives good grades in state and/or federal quality ratings
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Brain Death Is Legal Death
If someone’s brain dead, the damage is irreversible and, according to UK law, the person has died.
It can be confusing to be told someone has brain death, because their life support machine will keep their heart beating and their chest will still rise and fall with every breath from the ventilator.
But they will not ever regain consciousness or start breathing on their own again. They have already died.
Brain Death And Organ Donation
In some cases, a person who is brain dead may be a candidate for organ donation. If the person was a registered organ donor, or if their family knew of their wish to be an organ donor, their death is declared, but the ventilator is left on. Drugs that help preserve the internal organs are still given. The dead person then undergoes an operation to remove viable organs such as kidneys. After the operation is complete, the ventilator is switched off. Funeral arrangements can then be made by the family.
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The Heart Will Stop Beating Without A Ventilator
An article from LiveScience explains that some cases of brain death can be especially tough on families, because some of the bodily functions such as a heartbeat continue after brainwave activity has been shown to be absent.
In fact, the heart has an intrinsic electrical system that allows it to continue beating without assistance from the brain, and it can even continue beating outside of the body, it adds. However, without the assistance of a ventilator providing a continuous flow of oxygen and blood, this beating would stop very quickly, usually in less than an hour, it notes.
How Long Will A Brain
A 13-year-old girl in California continues to be on a ventilator after being declared brain-dead by doctors. Although a brain-dead person is not legally alive, how much of the body will keep on working with the help of technology, and for how long?
Jahi McMath of Oakland, Calif., was declared brain-dead last month after experiencing an extremely rare complication from tonsil surgery. Jahi’s family members have fought to keep their daughter on a ventilator, but a judge has ordered that the machine be turned off next week.
A person is considered brain-dead when he or she no longer has any neurological activity in the brain or brain stem meaning no electrical impulses are being sent between brain cells. Doctors perform a number of tests to determine whether someone is brain-dead, one of which checks whether the individual can initiate his or her own breath, a very primitive reflex carried out by the brain stem, said Dr. Diana Greene-Chandos, an assistant professor of neurological surgery and neurology at Ohio State University Wexner Medical Center. “It’s the last thing to go,” Greene-Chandos said.
In the United States and many other countries, a person is legally dead if he or she permanently loses all brain activity or all breathing and circulatory functions. In Jahi’s case, three doctors have concluded that she is brain-dead.
With just a ventilator, some biological processes including kidney and gastric functions can continue for about a week, Greene-Chandos said.
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What Happens After Coma And The Vs
The first sign of consciousness is usually visual tracking. This occurs when the patients eyes follow people or an object. Other signs include:
- Following simple instructions such as, Squeeze my hand, or Say your name.
- Communicating by saying words or indicating yes or no with head nods or gestures.
- Engaging in automatic behaviors like scratching the skin or crossing/uncrossing the legs.
People with brain injury will recover consciousness at a slow or fast rate, based on how severe their injury is. For people with very severe injuries, return of consciousness is a slow process. People with less severe injuries may move through the phases listed above quickly. Some of the stages described here may not be recognized or may not occur at all. For people with very severe injuries, recovery may stop at one of these stages.
Coma rarely lasts more than 4 weeks. Some patients move from coma to the VS. Others may move from coma to partial consciousness. It is rare for a person with severe brain injury to move directly from coma, or the VS, to full consciousness. People who are unconscious for a short time generally have had a less severe brain injury. As a result, they are likely to have a better recovery than people who are unconscious for a long time.
Another stage of recovery is called the minimally conscious state, or MCS. People in the MCS cant respond or communicate consistently.
Appendix: What Is The Soul
The debate over the metaphysics of death in the Catholic tradition necessarily involves discussions that appeal to the soul. Thus, I think that it is important that I provide an explanation of the soul for healthcare professionals not familiar with the Aristotelian philosophical tradition. Please note that this summary explanation does not and cannot include explanations for all the complexities that can arise in creation.
For Catholics, the fifteenth ecumenical council, the Council of Vienne , defined the rational or intellectual soul as the form of the human body and proposed this definition as an article of Catholic faith when it declared the following: In order that the truth of the pure faith may be known to all and the path to error barred, We define that from now on whoever presumes to assert, defend, or obstinately hold that the rational and intellectual soul is not of itself and essentially the form of the human body is to be censured as heretic . That is why it is important to understand the term, soul.
Given this background, it should be clear that the debate among Catholic philosophers and moral theologians over the legitimacy of the brain death criteria must first focus on whether the brain-dead patient is one, integrated, and continuing to develop along the particular human developmental pathway. If so, then he is not dead. If not, then he is.
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Features Of The Confusional State
- Acting lost or confused. This may include not being able to keep track of the correct place and time.
- Severe problems with attention, memory, and other mental abilities.
- Changes in level of responsiveness.
- Feeling very tired and sleeping during the day.
- Believing things that arent true.
- Seeing things that arent there.
Donation After Brain Death
Families of a brain dead patient must, by federal regulations, be provided the option of organ donation. If the family declines donation, the mechanical ventilator, medications and fluids are discontinued, after which the heart stops. If the family says yes to donation, the regional organ procurement organization is involved. The donors body is kept functioning by artificial means, such as ventilated support until the recovery of organs and tissue for life-saving transplant.
If you support donation it is important to document your decision. This removes the burden off of your loved ones to make the decision once you have passed away.
Brain Death Is Not The Same As Coma
Brain death differs from other states of unconsciousness in important ways. For example, coma is similar to deep sleep, except that no amount of external stimuli can prompt the brain to become awake and alert. However, the person is alive and recovery is possible. Brain death is often confused with a persistent vegetative state, but these conditions are not the same either. A persistent vegetative state means the person has lost higher brain functions, but their undamaged brain stem still allows essential functions like heart rate and respiration to continue. A person in a vegetative state is alive and may recover to some degree, given time. Brain death means the person has died.
Can You Recover From Brain Death
No, a patient who is brain dead will not be able to recover. The body may continue to breathe with mechanical support but eventually, both the breathing and heart will stop even with continued support.
Being brain dead is not the same as being in a coma or a prolonged vegetative state. The latter two are medical states where one may be unconscious but still show brain function.
The media and Hollywood often use these terms interchangeably. But both medically and legally, brain death is its own distinguishable diagnosis that one cannot recover from.
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Can A Brain Dead Person Open Their Eyes
A person who is brain dead is dead, with no chance of revival. Coma: A state of profound unresponsiveness as a result of severe illness or brain injury. Patients in a coma do not open their eyes or speak, and they do not exhibit purposeful behaviors. Some patients need ventilators while others do not
Brain Death Is Different From Vegetative State
The difference between brain death and a vegetative state, which can happen after extensive brain damage, is that it’s possible to recover from a vegetative state, but brain death is permanent.
Someone in a vegetative state still has a functioning brain stem, which means:
- some form of consciousness may exist
- breathing unaided is usually possible
- there’s a slim chance of recovery because the brain stem’s core functions may be unaffected
Someone in a vegetative state can show signs of being awake. For example, they may open their eyes but not respond to their surroundings.
In rare cases, a person in a vegetative state may show some sense of response that can be detected using a brain scan, but not be able to interact with their surroundings.
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Brain Restoration System Explores Hazy Territory Between Being Dead Or Alive
An experiment that restored cellular function to pigs brains hours after death holds the potential for advancing neuroscience research
One of the two legal definitions of death is irreversible cessation of all brain function, commonly known as brain death. It was widely believed that brain cells undergo rapidand irreversibledegeneration immediately after death. But a striking new study, in Nature, suggests that much functionality can be preserved or restoredeven hours after death. A research team, based primarily at the Yale School of Medicine, managed to revive some functions in the whole brains of pigs slaughtered four hours previously and to sustain them for a further six hours.
The work was motivated by the observation that cells can be harvested from postmortem brains and sustained in cell cultures for study, neuroscientist and team leader Nenad Sestan said in a press briefing: In short, if we can do this in a petri dish, can we do it in an intact brain? The system Sestan and his colleague developed, called BrainEx, comprises three elements: a computerized system of pumps, filters and reservoirs a blood substitute containing no cells but capable of carrying oxygen, along with numerous compounds designed to protect cells and a surgical procedure to hook everything up.
Left Ventricular Assist Device
An LVAD is used in cases of heart failure. Its a mechanical device that assists the left ventricle in pumping blood to the body.
Sometimes an LVAD becomes necessary when a person is awaiting a heart transplant. It doesnt replace the heart. It just helps the heart pump.
LVADs can have significant side effects, so a person on the heart transplant list might opt against having one implanted after evaluating their likely wait time and risk with their doctor.
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To Whom Is Our Duty Of Care
The concept of brain death is not often discussed in the public arena. According to the royal medical colleges in the United Kingdom and their faculties death of the brain stem is a component of brain death, and brain death is death. The criteria for brain stem death are well established, and their use in intensive care units enables treatment to be withdrawn from patients with brain stem death without recourse to the courts. Conversely, as a result of several high profile cases, persistent vegetative state has been reported on frequently in recent years. The application to the High Court in 1992 to discontinue life sustaining treatment for Tony Bland, who had been injured in the tragedy at Hillsborough football ground, brought the ethical debate to the front pages of the national press. Occasional stories of miraculous recoveries from comas are widely reported and may have led to an exaggeration of the small chances that patients have of recovering from a persistent vegetative state among a public that is increasingly well versed in this condition. This contrasts with the inevitable death from asystole which occurs within a few days for patients who are brain dead.