Check for updatesAnaesthesia 2023,78,330-336doi:10.1111/anae.15950GuidelinesThe use of cerebral computed tomographic angiography asan ancillary investigation to support a clinical diagnosis ofdeath using neurological criteria:a consensus guidelineE.O.Thomas,1 A.Manara,2R.A.Dineen,34A.Mortimer,5O.Aziz,P.Dean,7P.Elliott,8 D.M.Summers,910P.C.Whitfield,11 P.J.Hutchinson12 andD.Gardiner131 Consultant,Department of Intensive Care Medicine,University Hospitals NHS Trust Plymouth,UK and NeuroAnaesthesia and Critical Care Society representative2 Consultant,Department of Intensive Care Medicine,North Bristol NHS Trust,Bristol,UK3Professor of Neuroradiology,Faculty of Medicine and Health Sciences,University of Nottingham,UK4Honorary Consultant,Department of Radiology,Nottingham University Hospital NHS Trust,Nottingham,UK and BritishSociety of Neuroradiologists representative5Consultant,Department of Radiology,North Bristol NHS Trust,Bristol,UK6 Consultant,Bristol Royal Hospital for Children and University Hospital Bristol and Weston NHS Found ation Trust,Bristol,UK and Paediatric Critical Care Society representative7Consultant,Department of Intensive Care Medicine and Anaesthesia,East Lancashire Hospitals NHS Trust,Lancashire,UK and Intensive Care Society representative8Chair ofthe Lay Committee,Royal College of Anaesthetists and Faculty Intensive Care Medicine lay representative9Consultant,Department of Neuroradiology,NHS Lothian,Edinburgh,UK10 Honorary Senior Lecturer,University of Edinburgh,UK and British Society of Neuroradiologists representative11 Honorary Professor and Consultant,South West Neurosurgery Centre,University Hospitals NHS Trust Plymouth,UKand Society of British Neurological Surgeons representative12 Professor and Honorary Consultant,Department of Neurosurgery,University of Cambridge,Cambridge UniversityHospitals NHS Found ation Trust,Cambridge,UK and Society of British Neurological Surgeons representative13 Consultant,Department ofIntensive Care Medicine,Nottingham University Hospital NHS Trust,Nottingham,UK andFaculty of Intensive Care Medicine representativeSummaryThis multidisciplinary consensus statement was produced following a recommendation by the Faculty ofIntensive Care Medicine to develop a UK guideline for ancillary investigation,when one is required,tosupport the diagnosis of death using neurological criteria.A multidisciplinary panel reviewed the literatureand UK practice in the diagnosis of death using neurological criteria and recommended cerebral CTangiography as the ancillary investigation of choice when death cannot be confimmed by clinical criteriaalone.Cerebral CT angiography has been shown to have 100%specificity in supporting a diagnosis of deathusing neurological criteria and is an investigation available in all acute hospitals in the UK.A standardisedtechnique for performing the investigation is described alongside a reporting template.The panel wereunable to make recommendations for ancillary testing in children
