¿Cuál es la diferencia entre un coma y la muerte cerebral?

UPDATE: If you have family or loved ones currently in the hospital and you are discussing the potential to donate and save lives, click here.

Coma

Coma is a state of unarousable unresponsiveness.¹ A coma is a deep state of eyes-closed unconsciousness where a person is not able to respond to people or the environment around them. In a coma, a patient is alive and there is some brain activity. Depending on the severity of the injury, recovery time varies and comas can be temporary or permanent.

Los pacientes en coma pueden presentar respuestas del tronco encefálico, respiración espontánea y/o respuestas motoras no intencionadas. El coma tiene tres posibles desenlaces: progresión a la muerte cerebral, recuperación de la conciencia o evolución a un estado de conciencia crónicamente deprimida, como el estado vegetativo.

Los pacientes en coma no se tienen en cuenta para la donación de órganos, ojos o tejidos.

Muerte cerebral

According to the American Academy of Neurology, “Death by neurologic criteria, commonly referred to as brain death, occurs in individuals who have sustained catastrophic brain injury, with no evidence of function of the brain as a whole, a state that must be permanent.”² Brain death is legally and medically recognized as death. Brain death results from swelling in the brain; blood flow in the brain ceases and without blood to oxygenate the cells, the tissue dies.

The brain performs many functions, including thought, movement and all the neurological functions that allow the body to maintain blood pressure, heart rate, body temperature, hormones, breathing, etc. When a person deteriorates to brain death, the body’s entire system stops. You cannot breathe, your heart cannot beat and your body cannot function once your brain dies. Massive artificial medical measures must be started to maintain organ function (such as ventilated support), but these interventions are only a temporary measure.

Prueba de muerte cerebral

Organ Procurement Organizations (like LifeSource) do not make determinations of brain death. Instead, hospital clinicians who are separate from the donation and transplant process are responsible for determining and declaring death.

Physicians and health care providers conduct a comprehensive assessment to determine brain death, performing several tests to confirm there is no brain activity in accordance with strict medical standards.²

Only after brain death has been confirmed and the time of death noted, can organ donation become a possibility.

Donación tras muerte cerebral

La normativa federal obliga a ofrecer a las familias de un paciente con muerte cerebral la opción de donar órganos. Si la familia rechaza la donación, se suspenden el respirador artificial, los medicamentos y los líquidos, tras lo cual el corazón se detiene. Si la familia dice que sí a la donación, interviene la organización regional de obtención de órganos (LifeSource en MN, ND, SD). El cuerpo del donante se mantiene en funcionamiento por medios artificiales, como un respirador, hasta que se obtengan los órganos y tejidos para realizar un trasplante que salve vidas.

Si apoya la donación, es importante que documentar su decisión. De este modo, sus seres queridos no tendrán que tomar la decisión cuando usted fallezca. 

Citations:

Photo credit: Nature Reviews Steven LAUREYS MD PhD FEAN.

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