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The starting point of the study was to better support organ donation.
For the families of organ donors, as well as for the medical workers who work on them, it is emotionally and medically necessary to confirm that the donor has indeed died and that the death is irreversible.
, how long after the removal of life support equipment can it really be confirmed that there are no signs of life? There are still some doubts.
This forward-looking observation study, conducted in 20 ICUs in three countries, focused on an analysis of the rate and time of occurrence of electrical and pulse activity in adult end-of-life centers following the planned removal of life-support equipment, with an expected monitoring time of 30 minutes and close observation and recording by clinicians at the bedside.
team found that death is not always as simple as the well-known "flattening" of the guardianship signal curve.
during death, cardiac activity may resume several times until it is eventually completely stopped - but no one resumes blood circulation or consciousness in the process.
of all 631 end-of-life patients, bedside clinicians reported five (1%) cases (1%) of which showed a "one-time recovery" of heart or respiratory activity during the end-of-life process.
retrospective analysis of end-of-life electrostatgrams and blood pressure change curves in 480 deaths found that 67 (14%) briefly resumed heart activity after a period of no pulse, including 5 reported by bedside clinicians.
from no signs of pulse to the restoration of heart activity, with a maximum interval of 4 minutes and 20 seconds.
of all dying people, the end-of-life electrostatgram QRS wave group had a 19% matching rate with the pulse.
the study provides supporting evidence for current standards - waiting five minutes after cardiac activity stops before confirming death and organ donation.
, it will reassure more donor families and medical teams about the standard.
References to the World, Sonny Dhanani, et al., (2021). Resumption of Cardiac Activity after Withdrawal of Life-Sustaining Measures. N Engl J Med, DOI: 10.1056/NEJMoa2022713 [2] When is dead really dead?. Retrieved January 28, 2020, from
