The OPO searches to see if the deceased is registered as a donor, which serves as legal consent; if the deceased has not registered or otherwise noted consent (e.g., on a drivers license), the OPO will ask the next of kin for authorization. The patient is kept on ventilator support until the organs have been surgically removed. If the patient has indicated in an advance health care directive that they do not wish to receive mechanical ventilation or has specified a do-not-resuscitate(DNR) order and the patient has also indicated that they wish to donate their organs, some vital organs such as the heart and lungs may not be able to be recovered. Demographics
United States
Brain death is responsible for 2% of all adult and 5% of pediatric in-hospital deaths in the United States. In a nationwide survey of pediatric intensive care units (PICU) in the United States in 2019; there were more than 3,000 pediatric brain deaths out of a total of more than 15,344 children who died in PICUs. According to a national study, "brain death evaluations are performed infrequently, even in large PICUs." See also
Eamonn Walker

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Infants born prematurely can be intubated for a longer amount of time due to the fact that they have more flexible cartilage and a larynx located high in the airway. 90% of acquired cases in children are due to intubation, due to the ring of cartilage in the upper airway. Less commonly, infections, such as bacterial tracheitis, tuberculosis, histoplasmosis, diphtheria, and laryngeal papillomatosis can cause it. Systemic diseases, such as amyloidosis, granulomatosis with polyangiitis, sarcoidosis, inflammatory bowel disease, scleroderma, relapsing polychondritis, and polyarthritis, can also cause it. Other causes may include aspiration of foreign bodies, burns, and exposure to occupational hazards. Very rarely, the condition may also have no known cause, in which case it is known as idiopathic subglottic stenosis. Mechanism
High cuff pressure or long-term intubation can cause damage to the tracheal mucosa, causing inflammation, ulceration, and breakdown of cartilage. When the injury heals, scarring occurs, narrowing the airway. Treatment-related risk factors include repeated intubation, the presence of a nasogastric tube, and size of an endotracheal tube. Person-related risk factors include systemic diseases, the likelihood of infection, and inadequate perfusion. Acid reflux may cause narrowing due to scarring resulting from stomach acid damaging the tracheal mucosa. 10-23% of causes result due to narrowing arising from granulomatosis with polyangiitis. In these cases, it is believed that this is more common in people under the age of 20. Around 66% of sarcoidosis cases involve the airway. Diagnosis
CT scans and MRI (magnetic resonance imaging) can help in diagnosis.