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Hypothalamic-Pituitary Function in Brain Death

Title: Hypothalamic-Pituitary Function in Brain Death: A Review.
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Name(s): Nair-Collins, Michael, author
Northrup, Jesse, author
Olcese, James, author
Type of Resource: text
Genre: Text
Issuance: serial
Date Issued: 2014
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: The Uniform Determination of Death Act (UDDA) states that an individual is dead when "all functions of the entire brain" have ceased irreversibly. However, it has been questioned whether some functions of the hypothalamus, particularly osmoregulation, can continue after the clinical diagnosis of brain death (BD). In order to learn whether parts of the hypothalamus can continue to function after the diagnosis of BD, we performed 2 separate systematic searches of the MEDLINE database, corresponding to the functions of the posterior and anterior pituitary. No meta-analysis is possible due to nonuniformity in the clinical literature. However, some modest generalizations can reasonably be drawn from a narrative review and from anatomic considerations that explain why these findings should be expected. We found evidence suggesting the preservation of hypothalamic function, including secretion of hypophysiotropic hormones, responsiveness to anterior pituitary stimulation, and osmoregulation, in a substantial proportion of patients declared dead by neurological criteria. We discuss several possible explanations for these findings. We conclude by suggesting that additional clinical research with strict inclusion criteria is necessary and further that a more nuanced and forthright public dialogue is needed, particularly since standard diagnostic practices and the UDDA may not be entirely in accord.
Identifier: FSU_migr_mhs-0041 (IID), 10.1177/0885066614527410 (DOI)
Keywords: Uniform Determination of Death Act, brain death, diabetes insipidus, hypothalamus, pituitary
Note: Originally published in Journal of Intensive Care Medicine: http://jic.sagepub.com/content/early/2014/03/29/0885066614527410.long
Citation: Nair-Collins M, Northrup J, & Olcese J. (2014). Hypothalamic-pituitary function in brain death: A review. J Intensive Care Med. 2014 Mar 31.
Subject(s): Professional ethics
Medical laws and legislation
Medical policy
Life sciences
Medicine and the humanities
Medical sciences
Neurobiology
Neurosciences
Physiology
Links: http://dx.doi.org/10.1177/0885066614527410
Persistent Link to This Record: http://purl.flvc.org/fsu/fd/FSU_migr_mhs-0041
Owner Institution: FSU
Is Part of Series: Behavioral Sciences and Social Medicine Faculty Publications.
Is Part Of: Journal of Intensive Care Medicine.

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Nair-Collins, M., Northrup, J., & Olcese, J. (2014). Hypothalamic-Pituitary Function in Brain Death: A Review. Journal Of Intensive Care Medicine. Retrieved from http://dx.doi.org/10.1177/0885066614527410