Death of the brain. The statement of death. Clinical death

The work of the brain determines the very existence and all the qualities of the human personality, so the death of the brain is the boundary separating being from non-being.

How does a person die?

Dying is not a one-time event, but a wholea process in which all bodies and systems cease to function. The duration of this process depends on many factors: the initial level of health, the temperature of the environment, the severity of injury, hereditary factors. In practice, it is required to know exactly whether the death of the brain has come as an organ.

A person with a deceased brain can no longer be fullyto be considered alive, although his heart, lungs and other organs can be healthy and function perfectly. The personality of such a half-ruble ceases to exist. At the same time, undamaged organs can be used for donation, saving several other lives. This is a complex legal and ethical issue, in which everything should be extremely clear. Every person has relatives, and the question of life and death is extremely important for them.

The concept of clinical and biological death

Death is considered clinical whena person can still be brought back to life. Moreover, the return must take place in full, with preservation of all personal properties. Clinical death is a borderline form of existence between two worlds, when it is equally possible to move both in one direction and in another direction.

Clinical death begins when you stopbreathing and heartbeat. A person is no longer breathing and his heart is not beating, but pathological processes have not yet become irreversible. Have not yet had time to undergo metabolic processes of destruction, and recovery without losses is possible. If within 5-6 minutes it is possible to restore vital functions, then a person simply wakes up, as if from a dream. But leaving without help in a state of clinical death leads to a true or biological death, when the organism becomes an open ecosystem for the development of bacteria. The surrounding people have no more than 5 minutes to prevent a person from dying. At the same time, brain death stands out as a separate species because after this event a person can continue life vegetative, but not personal.

Signs of brain death

Although the criteria that determine the death of the brain have been studiedit is enough, after ascertaining this fact, the person is left under supervision in conditions of resuscitation department for at least 24 hours. At the same time, artificial ventilation of the lungs continues and maintenance of cardiac activity. Cases of a return to normal life after the death of the brain are unknown, but the decision to disconnect from the equipment to maintain life is too responsible, and haste is unacceptable.

The following criteria for brain death have been adopted worldwide:

• lack of consciousness and independent movements;
• absence of any reflexes, including such ancient ones as oculomotor and swallowing;
• lack of independent breathing, special tests with hyperventilation are performed for testing;
• isoline (zero axis) on the electroencephalogram;
• additional signs in the form of a sharp decrease in muscle tone, rise of the sugar curve and the like.

The presence of independent heartbeats -only confirmation that in the heart there are autonomic nervous nodes or drivers of rhythm. However, the central regulation of the heart rate is lost, and blood circulation can not be effective. The heart rate usually ranges between 40-60 beats per minute, and it lasts a very short time.

Is it possible to live without a brain?

Life and death are states continuously followingone by one. Complete brain death means the onset of a chronic vegetative state - one that people call "vegetable" or life on machines. Outwardly, a person can not change in any way, but everything that was in him human - thoughts, character, lively speech, sympathy, knowledge and memory - are lost forever. In fact, the extension of the vegetative state depends on the voltage in the electrical network. As soon as the devices stop working, the vegetative existence of the person with the deceased brain ends, too.

Very important is the cause of brain damage,without its clarification it is impossible to ascertain death. It can be trauma, hemorrhagic stroke, dropsy or deep brain swelling, incompatible with life poisoning and other undisputed conditions. In all cases, when there is even the slightest doubt as to the cause of brain death, a person's condition is considered comatose and a continuation of resuscitation is required.

Does a coma end with death?

No, this ends only the transcendental coma. Doctors distinguish 4 stages of coma, the last stage is beyond. In a state of coma, life and death balance on the brink, there is a possibility of recovery or deterioration.

Coma is a sharp suppression of the functions of all parts of the brain, a desperate attempt to survive by changing the metabolism. In the development of coma, bark, subcortex and stem structures are involved.

The causes of coma are huge: diabetes, severe kidney disease, dehydration and loss of electrolytes, liver cirrhosis, toxic goiter, intoxication with external poisons, deep oxygen starvation, overheating and other gross disorders of life.

Doctors of antiquity called someone a "dream of reason"because in a state of even a shallow and reversible coma, a person is inaccessible to contact, communication with him is impossible. Fortunately, modern medicine has many options for treating coma.

How does the death occur?

In the Russian Federation the statement of death and terminationResuscitative measures are regulated by Government Decision No. 950 of 20.09.2012. The Resolution details all medical criteria. To establish death in a medical institution can be a consultation of 3 doctors who have worked for at least 5 years. No one from the consultation can be related to organ transplantation. Necessarily the presence of a neurologist and anesthesiologist.

Death occurring at home or in the publicplace, state first aid workers. In all cases where death occurred without witnesses, police officers are called to examine the body. In all disputable situations, when the cause of death is unknown, a forensic medical examination is carried out. This is necessary to establish the category of death - violent or not. At the end of all actions, the relatives are given a basic official document - a certificate of death.

Is it possible to postpone the day of death?

Scientists answer this question positively ornegative with approximately equal frequency. In numerous forecasts, the day of death is associated with a lifestyle, bad habits and type of nutrition. In many religious movements death is seen as a stage of transition to a new kind of being of the soul without burdening the body shell.

Buddhism and Hinduism are inextricably linked with reincarnation or the embodiment of the soul in a new body. At the same time, the choice of a new body depends on what kind of lifestyle people lead in their earthly incarnation.

Christianity views the day of death as the beginningspiritual life, heavenly reward for righteousness. The presence of an afterlife spiritual life - better than the earthly life - fills the believer's life with a high sense.

In practice, an important role is played by intuition,allowing to avoid a mortal danger. It is by intuition that numerous cases of late arrivals to airplanes and watercraft, which later suffer fatal crashes, are explained. People know too little about their nature in order to be able to explain how and why they leave the deadly place in seconds before the tragedy.

What are the kinds of deaths?

Physicians identify 3 types of nonviolent death:

• physiological or from old age;
• pathological or from illness;
• suddenly or from sudden acute conditions.

Sudden death is one of the mosttragic, when a person ceases to live among full well-being. Most often, this end results in sudden cardiac arrest, which can occur in both the adult and the child.

The heart is a very complex organ, comparing it withsimple pump is incorrect. In addition to specially organized cells - cardiocytes forming cavities - it has an autonomic nervous system. All this is controlled by the brain and spinal cord, and also reacts to the hormones and electrolytes contained in the blood. Failure of any of the components can lead to a sudden stop.

In fact, sudden cardiac arrest is the collapse of all life support systems. Blood stops transferring oxygen and removing metabolic products, life simply stops.

Anyone who is close to you should startmanual cardiopulmonary resuscitation. Through the efforts of others, one can sustain life up to half an hour. This time is enough for the arrival of doctors who will provide specialized assistance.

Cessation of brain function - a separate type of death

At doctors the death of a brain is considereda separate diagnosis, fatal for a person. The fact is that the brain consists of two main parts: the hemispheres and the brain stem. Hemispheres are responsible for higher nervous functions: speech, thinking, memory, logic and emotions. The loss of these functions can be seen in people who have had a stroke: lack of speech and tearfulness - the consequences of the destruction of the hemispheres with blood. You can live with damaged hemispheres, and for a long time.

Unlike the hemispheres, the brain stem is moreancient education. It was formed when people still did not know not only writing, but coherent speech. The brain stem controls vital functions, namely breathing, palpitation, muscle tone and reflexes. Any, the most insignificant damage to the brain stem causes a state of clinical death. However, people survive precisely because of the brainstem. All its structures are most resistant to external influences and are damaged last.

So when does the brain die?

Then, when the brain stem dies. The brain dies, too, not in an instant. There is a general rule for the whole organism: what in the process of evolution was formed later, dies first. This rule applies to the brain. Hemispheres - younger formations - are more vulnerable in a moment of mortal danger. They die first from lack of oxygen. If the severity of the condition is too deep and the resuscitation measures are ineffective, a full brain death occurs within a matter of minutes.

Have all the secrets been revealed by scientists?

Daily in specialized publicationsthere appears at least one publication about new discoveries that accompany the process of dying. Thus, scientists argue that the time of death of the brain can be fixed on the EEG as a burst of electrical activity, characteristic of intensive learning processes. Other scientists characterize such activity as the recording of bioelectric waves from collapsing neurons. There is still no definitive answer.

Consolation to all living things can serve as the words of the Greek philosopher Epicurus that we will never meet with death: when we are there is no death, and when it comes, there is no longer us.