Neurologic Recovery after an Exam Consistent With Brain Death in an Adolescent with Severe Asthma - Abstract
This report describes a 13 year-old female with a history of asthma who presented in acute respiratory failure with profound hypercarbia secondary to status asthmaticus. On admission to our PICU, her neurologic exam was consistent with brain death. Her respiratory symptoms were treated with bronchodilating agents including terbutaline, magnesium, aminophylline and epinephrine infusions, as well as inhaled sevoflurane. Upon resolution of the severe hypercarbia, her neurologic status improved. She was ultimately extubated on day six of admission and discharged to an inpatient
rehabilitation facility approximately one week later. At one year follow up the patient was back to school and had made a full recovery with no detectable neurologic deficits. Clinical and neuroradiographic changes consistent with brain death may be associated with high PaCO2 levels and amenable to treatments directed against the bronchospasm and respiratory failure. Only after the hypercarbia has resolved can the patient’s neurologic outcome be accurately prognosticated.