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Families Experience of a Relatives Brain Stem Death Diagnosis: A Systematic Review

Cade-Smith, E.; Mackay, L.; Wijayatilake, D. S.; Kingsley, M.; Shaikh, M.

2023-03-09 intensive care and critical care medicine
10.1101/2023.03.09.23287057 medRxiv
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AIMBeing diagnosed as Brain Stem Dead is a very challenging experience for families. Most research regarding brain stem death focuses on Organ Donation and there is currently little research into families experience of brain stem death. The aim is to review the familys experience of brain stem death. DESIGNSystematic review METHODA narrative synthesis was conducted for 9 studies including qualitative and quantitative study designs. Four electronic databases: AHMED (Allied and Complimentary Medicine), Emcare (1995-present), Medline (Ovid) and APA Psych Info (Ovid) were searched. No limit was placed on date of publishing due to this being a relatively under researched topic. The original search was conducted on 4th November 2021 and rerun on 6th December 2022 to ensure the inclusion of any new published studies. RESULTSSix main themes were identified, including: The Unexpected Prognosis; Coming to terms with brain stem death- grieving process; Request for organ donation; Observing brain stem death testing; The impact of staff on families experience; and the lasting impact. CONCLUSIONFamilies of patients with brain stem death are often left with a lack of understanding surrounding the diagnosis, the process, and the short and long term distress it can cause. There is need for research into familys experiences and brain stem death testing specifically so that more reliable data can be produced. There is a need to establish national, or international practice surrounding family care in intensive care in cases of brain stem death. This review highlights the importance of establishing specific brain stem death protocols, enabling more effective and consistent support for families.

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