Care of the brain-dead organ donor

Confounding factors in brain death: Cardiogenic ventilator autotriggering and implications for organ transplantation

“…This produces significant tachycardia, hypertension, increased cardiac output and stroke volume. Cardiovascular instability phase two is characterised by a low-resistance, vasodilated state (Arbour, 2005(Arbour, , 2009Bugge, 2009;Mascia et al, 2009;Linos et al, 2007;Shah, 2008;Ullah et al, 2006). This may contribute to increased cardiac output and stroke volume.…”

“…There are two general stages of cardiovascular instability associated with brainstem herniation. Stage one is characterised by massive sympathetic outflow and catecholamine levels significantly above baseline as well as elevated mAP consequent to rising pressure on the brainstem in an effort to augment brain perfusion in the setting of life-threatening intracranial pressure (ICP) elevations (Arbour, 2005(Arbour, , 2009Bugge, 2009;Mascia et al, 2009;Linos et al, 2007;Shah, 2008;Ullah et al, 2006). This produces significant tachycardia, hypertension, increased cardiac output and stroke volume.…”

Diretrizes para manutenção de múltiplos órgãos no potencial doador adulto falecido: parte I. Aspectos gerais e suporte hemodinâmico

“…(25,26,86) Heart arrhythmias may cause reduced heart output and hemodynamic instability. The cause of arrhythmias is multi-factorial, although the most frequent causes include hypovolemia, hypotension, hypothermia, the use of catecholamine drugs, myocardial contusion, acid-base disorders and electrolyte disturbances.…”

“…(12,36) These arrhythmias are related to ischemia of the brain stem and sympathetic hyperactivity (sympathetic storming), which results in conduction system necrosis and myocardial injury (D). (18,86) Other causes may include metabolic and electrolyte imbalances, such as hyperkalemia and hypomagnesemia, which are common in cases of brain death. Other contributing factors may include sympathomimetic drugs, which may be required for hemodynamic control (D).…”

Brain Death and True Patient Care

“…6 See, for instance, Wijdicks (2001); Wijdicks et al (2010). 7 See, for example, Soifer and Gelb (1989); Linos et al (2007). 8 For self-evident reasons related to the health of the organs, 85% of all donors fall within the age group from the second to the fifth decade of life (data retrieved from the Organ Procurement and Transplantation Network [2015]).…”