What are the reversible causes of coma and apnoea that must be excluded in brain death?

Coma

Specific criteria are laid out in guidance from the AOMRC

  • Metabolic or endocrine disturbance
  • Circulatory disturbance
  • Sedative/depressant drugs
  • Hypothermia
Apnoea

Rare but should be actively sought if the history or clinical examination suggests their presence

  • Severe neuromuscular weakness of any cause
  • Spinal cord injury following trauma – should be excluded through x-ray, CT or MRI imaging
  • Residual neuromuscular blockade - it is sensible to routinely use a nerve stimulator to confirm the absence of drug-related block