Rafael Badenes, professor of Surgery of the University of Valencia and surgeon at the University Clinical Hospital of Valencia.

Rafael Badenes, professor at the Department of Surgery of the University of valencia, is one of the signatories of an article published in the prestigious Journal of the American Medical Association (JAMA), in which a protocol is established to homogenise worldwide the determination of brain death causes.

The article, «Brain Death/Death by Neurologic Criteria around the World: The World Brain Death Project», signed by specialists from 20 countries, provides recommendations on the minimum clinical standards to determine brain death or death by neurological criteria, with clear guidance for clinical practice. The proposals, approved by 5 federations and 27 medical associations worldwide, can serve to help societies and countries in the review or development of protocols and procedures to determine brain death and want to offer a greater consistency of this practice within and between countries.

“Given the great variability existing around the world regarding the criteria for brain death, we have deemed necessary to unify them, and give valid recommendations for any country. In addition, we give guidelines for action in new scenarios, such as the determination of brain death in a patient with ECMO (extracorporeal membrane oxygenation) or in hypothermia”, declared Rafael Badenes, also head of the Anesthesiology and Resuscitation section at the University Clinical Hospital of Valencia.

The publication, with 17 supplements, has been based on the scientific literature and the opinion of 45 experts, ranging from adult and pediatric care, neurology, neurosurgery and anesthesiology, among others. The scope of work includes prior factors and how to conduct clinical trials, as well as guidance on religious and legal issues. These recommendations have been prepared for a pragmatic management and applicable to all types of hospitals.

The Spanish entities that have supported this work are the Spanish society of Anesthesiology, Resuscitation and pain Therapeutics (SEDAR), the Spanish Society of neurosurgery (SENEC) and the Spanish society of Neurology (SEN). At European level, the endorsement of the European Society of Intensive Care Medicine (ESICM) stands out.

Article: Greer DM, Shemie SD, Lewis A, et al. «Determination of Brain Death/Death by Neurologic Criteria: The World Brain Death Project». JAMA. Published online August 03, 2020. doi:10.1001/jama.2020.11586