Akademik Veri Yönetim Sistemi
Child's Nervous System, cilt.42, sa.1, 2026 (SCI-Expanded, Scopus)
Objective: Brain death (BD) is defined as the irreversible loss of all brain functions resulting from non-recoverable brain injury. The aim of this study was to evaluate the knowledge, practices, and challenges encountered by pediatric neurology (PN) and pediatric intensive care (PIC) specialists in Turkey regarding BD diagnosis and related processes. Design: Cross-sectional, descriptive study based on a structured online survey. Setting: Nationwide multicenter study involving hospitals across seven geographical regions of Turkey. Subjects: A total of 100 specialists (54 PN and 46 PIC) participated in the study. Interventions: An online survey comprising 41 questions on diagnostic procedures, organ donation processes, and family communication was administered to PN and PIC specialists. Measurements and main results: Eighty-six percent of respondents had previously declared BD. The median annual pediatric BD declaration was 5, with 67.4% of centers performing organ transplantation. However, 42.4% reported no organ donations in the past year. While 81.4% of PIC specialists considered their training adequate, only 53.5% of PN specialists agreed (p < 0.001). Multiple centers (69.8%) had transplant coordination services, but 25.6% of respondents reported insufficient support in this regard. The view that a single apnea test is sufficient for BD diagnosis was held by 83.7% of PIC and 65.1% of PN specialists (p = 0.045). When apnea testing was unfeasible, 88.4% of PIC and 65.1% of PN specialists considered cerebral blood flow studies adequate for BD confirmation (p = 0.011). Of the participants, 72.1% routinely used neuroimaging, with CT angiography being the most preferred method (77.9%). In patients designated as potential donors, 53.5% of PIC specialists refrained from initiating additional therapies. Conclusions: This is the first systematic comparison of expert opinions on the pediatric BD diagnostic process in Turkey. The findings underscore an urgent need for the development of multidisciplinary guidelines and nationwide standardization.