This means no behavioral or reflex responses mediated above the spinal cord. Brainstem functions must be absent. This includes unreactive pupils, the absence of ocular responses, facial sensation and motor responses, and lack of cough and gag reflexes. The patient must be apneic. This means absence of spontaneous respirations in response to a hypercarbic stimulus.
Brain death is a clinical diagnosis.
Once a patient has been declared officially and legally brain dead, they are disconnected from the ventilator. The only exception occurs when the family of the patient might consider organ donation. My loved one is in a coma, the prognosis is dismal, and he or she wouldn't want to be maintained this way. These interventions may include mechanical ventilation, surgery, antibiotics, blood pressure medications, general medications, blood transfusions, blood draws, feedings, and fluids. Discussions regarding the withholding or withdrawal of treatment are raised only after there is clear clinical evidence that current treatment has not resulted in desired outcomes and there is little or no chance of meaningful patient recovery.