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학술저널
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김도형 (성균관대학교 의과대학 삼성창원병원 신경과) 권오영 (경상대학교 의과대학 신경과학교실) 양태원 (경상대학교) 김민화 (한국장기조직기증원) 이정림 (한국장기조직기증원) 조원현 (한국장기조직기증원) Jung Sook Yeom (Gyeongsang National University Hospital) Young-Soo Kim (Gyeongsang National University Hospital)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.35 No.11
발행연도
2020.1
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1 - 9 (9page)

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Background: Brain death is a clinical diagnosis that implies irreversible loss of function of the entire brain, including the brainstem and both hemispheres. Based on previous reports, it is not rare for reflex and spontaneous movements to occur in patients during the process of determinin brain death. However, reports of the frequency and common types of these movements vary from study to study. Thus, we evaluated adult patients with impending brain death in Korea to determine the frequency and characteristics of reflex and spontaneous movements. Methods: Brain dead patients who were admitted to 15 hospitals in the Yeongnam region (Southeast) of Korea were recruited prospectively from January 2013 to September 2016. All patients met the criteria for brain death as established by the Korea Medical Association. All body movements occurred during the process of diagnosing brain death and were assessed by physicians and trained organ transplant coordinators. The frequency and characteristics of these movements were identified and the demographic and clinical factors of impending brain dead patients with and without these movements were compared. Results: A total of 436 patients who met the criteria for brain death were enrolled during the study period. Of these patients, 74 (17.0%) exhibited either reflex or spontaneous movements Of this subset, 45 (60.8%) exhibited reflex movements only, 18 (24.3%) exhibited spontaneou movements only, and 11 (14.9%) exhibited both reflex and spontaneous movements. The mos common reflex movements were the flexor/extensor plantar response and spinal myoclonus. Of the 74 patients, 52 (70.3%) exhibited one movement of the same pattern and 22 (29.7%) exhibited two or more different movement patterns. In addition, 45 (60.8%) exhibited these movements only on a limited area of the body with the leg being most common (n = 26, 57.8%). Patients with hypoxic brain damage and a higher systolic blood pressure exhibited significantly more reflex or spontaneous movements. Conclusion: Movements associated with brain dead patients are not rare and thus an awareness of these movements is important to brain death diagnosis. Physicians who perform brain death examinations should understand the frequency and characteristics of these movements to reduce delays in determining brain death.
#Brain Death #Reflex #Movement

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참고문헌 (11)

참고문헌 신청
Ivan LP / 1973 / Spinal reflexes in cerebral death / Neurology 23(6):650~652 google schola Jorgensen EO / 1973 / Spinal man after brain death. The unilateral extension-pronation reflex of the upper limb as an indication of brain death / Acta Neurochir(Wien) 28(4):259~273 google schola Döşemeci L / 2004 / Frequency of spinal reflex movements in brain-dead patients / Transplant Proc 36(1):17~19 google schola Saposnik G / 2005 / Spontaneous and reflex movements in 107 patients with brain death / Am J Med 118(3):311~314 google schola Suk Geun Han / 2006 / Reflex Movements in Patients with Brain Death: A Prospective Study in A Tertiary Medical Center / Journal of Korean Medical Science 21(3):588~590 google schola

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