A 65-Year-Old Man Was Admitted to the Intensive Care Unit

A 65-year-old man was admitted to the intensive care unit after going into cardiac arrest when alone at home.  Cardiopulmonary resuscitation and advanced cardiac life support were performed extensively in the field, and return of spontaneous circulation was eventually achieved.  Two days later, he remains intubated and is on full ventilator support.  The patient is unresponsive to verbal and tactile stimuli.  His temperature is 37.2 C (99 F) , blood pressure is 110/70 mm Hg, and pulse is 70/min.  The treating physician discusses with the patient's family the possibility of brain death.
Which of the following is most consistent with the criteria for brain death?

A) Absence of respiratory drive for 3 minutes off the ventilator
B) Body temperature <35 C (95 F)
C) Intermittent cerebral circulation on cerebral Doppler scanning
D) Irreversible absence of cerebral and brain stem reflexes
E) Nonspecific waveforms on electroencephalogram

Correct Answer:

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