Recommendations of the German Society for Clinical Neurophysiology and Functional Imaging for the Diagnosis of Irreversible Loss of Brain Function

Along with the Fifth Update of the German Medical Association guideline for the determination of the irreversible loss of brain function (brain death/death by neurologic criteria), effective from September 2022, the recommendations of the German Society for Clinical Neurophysiology and Functional Imaging (DGKN) for the ancillary electrophysiological (electroencephalography, early auditory evoked potentials, somatosensory evoked potentials) and neurovascular (Doppler sonography, duplex sonography) tests were updated. In particular, for Doppler and duplex sonography age-related minimum levels of mean arterial blood pressure in children were specified, and the applicability of sonography in patients with extracorporeal membrane oxygenation (ECMO) depending on the ECMO mode was determined. For the electrophysiological methods unified specifications of electrode use and the inter-electrode difference of skin-electrode impedances were newly formulated.These herewith presented recommendations describe the indications, the limitations, the requirements and the execution of these ancillary tests in the diagnosis of irreversible loss of brain function in children and adults.