Design and created by Guideline Central in participation with the American Academy of Neurology, American Academy of Pediatrics, Congress of Neurological Surgeons, and Society of Critical Care Medicine.
American Academy of Neurology
American Academy of Pediatrics
Congress of Neurological Surgeons
Society of Critical Care Medicine
Publication Date: Oct 11, 2023
Page Last Updated: May 5, 2026
| Classification | Definition |
|---|---|
| Level (A) | Denotes a practice recommendation that must be done. In almost all circumstances, adherence to the recommendation will improve healthrelated outcomes. Almost all patients in this circumstance would desire that the recommendation be followed. |
| Level (B) | Corresponds to the helping verb should. Should recommendations tend to be more common, as the requirements are less stringent but still based on the evidence and benefit-risk profile. |
| Level (C) | Corresponds to the helping verb may. May recommendations represent the lowest allowable recommendation level the AAN considers useful within the scope of clinical practice and can accommodate the highest degree of practice variation. |
| Level (U) | Indicates that the available evidence is insufficient to support or refute the efficacy of an intervention. |
| Level (R) | Assigned when the balance of benefits and harms is unknown and the intervention is known to be exorbitantly expensive or have important risks. This level designates that the intervention should not be used outside of a research setting. |
* In exceptional cases, one convincing Class I study may suffice for an "A" recommendation if 1) all criteria are met, 2) the magnitude of effect is large (relative rate improved outcome > 5 and the lower limit of the confidence interval is > 2).
American Academy of Pediatrics
Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Guideline
Report of the AAN Guidelines Subcommittee, AAP, CNS, and SCCM
David M. Greer, Matthew P. Kirschen, Ariane Lewis, Gary S. Gronseth, Alexander Rae-Grant, Stephen Ashwal, Maya A. Babu, David F. Bauer, Lori Billinghurst, Amanda Corey, Sonia Partap, Michael A. Rubin, Lori Shutter, Courtney Takahashi, Robert C. Tasker, Panayiotis Nicolaou Varelas, Eelco Wijdicks, Amy Bennett, Scott R. Wessels, John J. Halperin
Neurology Oct 2023, 10.1212/WNL.0000000000207740; DOI: 10.1212/WNL.0000000000207740
The purpose of this guideline is to update the 2010 American Academy of Neurology (AAN) brain death/death by neurologic criteria (BD/DNC) guideline for adults and the 2011 American Academy of Pediatrics, Child Neurology Society, and Society of Critical Care Medicine guideline for infants and children and to clarify the BD/DNC determination process by integrating guidance for adults and children into a single guideline. Updates in this guideline include guidance related to conducting the BD/DNC evaluation in the context of extracorporeal membrane oxygenation, targeted temperature management, and primary infratentorial injury.
D001926 - Brain Death
D001921 - Brain
D001926 - Brain Death
D001921 - Brain
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