Organ Donation : Intensive Care Issues in Managing Brain Dead

Murthy, Tvsp

doi:10.1016/s0377-1237(09)80132-9

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…Whilst the optimum management of this cardiovascular instability remains to be elucidated, it has been postulated that restoration of euvolemia is associated with improved postoperative graft function. A combination of crystalloids, colloids and blood components have been used to achieve this, and it has been suggested that sensible therapeutic objectives include maintaining a haemoglobin concentration above 10 g/dL and restoring intravascular volume, and colloid oncotic pressure [91].…”

Section: Managing Donor Complications Associated With Donation After mentioning

confidence: 99%

Review 1: Lung transplant—from donor selection to graft preparation

et al. 2020

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For various end-stage lung diseases, lung transplantation remains one of the only viable treatment options. While the demand for lung transplantation has steadily risen over the last few decades, the availability of donor grafts is limited, which have resulted in progressively longer waiting lists. In the early years of lung transplantation, only the 'ideal' donor grafts are considered for transplantation. Due to the donor shortages, there is ongoing discussion about the safe use of 'suboptimal' grafts to expand the donor pool. In this review, we will discuss the considerations around donor selection, donor-recipient matching, graft preparation and graft optimisation.

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Section: Managing Donor Complications Associated With Donation After mentioning

confidence: 99%

Review 1: Lung transplant—from donor selection to graft preparation

et al. 2020

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“…Death itself is an irreversible phenomenon, presented as the cessation of the functioning of vital organs, and the permanent absence of brain and brainstem function 2 , beginning with an apnoeic unresponsive coma. breathing, circulation, normal body temperature, liquid, electrolytic and acid-base balance are maintained to prevent possible infections, and several clinical investigations occur 3 . Healthcare professionals are faced with the so-called paradox of the brain-dead person: a person who still breathes and still feels warm when touched.…”

Section: Introductionmentioning

confidence: 99%

Organ Donation: Experience in the Maintenance of a Brain-Dead Donor

Jurak¹,

Starc²

2018

J. appl. health sci.

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Background: brain death is an irreversible biological event, and is the permanent cessation of functions of the brain and brainstem. Transplantation has become an established method of treatment of many, near-terminal patients. Methods:The sample consisted of three groups: doctors, registered nurses, and nursing assistants. The research was carried out in the Intensive Care Unit of the University Medical Centre Ljubljana, Department of Anaesthesiology and Surgical Intensive Therapy Department and at the Clinical Department of Vascular Neurology and Intensive Neurological Therapy. Data were collected using a questionnaire and semi-structured interviews.Results: Women experience more stress when working with brain-dead donors than men do. We conclude that the work with a brain-dead organ donor represents a specific situation and has little in common with the factors that affect the overall satisfaction of healthcare professionals. Healthcare professionals who are undecided about the donation of their own organs are against organ donation in general. It has been shown that there is a lack of education and communication on the maintenance of brain-dead donors. Conclusions:Work with brain-dead donors is almost routine work in intensive care units. Some healthcare professionals perceive a brain-dead organ donor like any other patient, but within a defined protocol.Keywords: brain death, transplantation activity, brain-dead organ donor, stress, experiences of health professionals. -27 Ethical approval was obtained prior to the commencement of the study.For the quantitative analysis, a validated questionnaire was used. In the initial phase, a pilot study was conducted, which lasted from 8 to 22 September 2014. Along with the participants' demographics, the questionnaire included statements (5-scale Likert), which measured the individuals' working environment (α = .750) and the way of coping with stress (α = .690).J. appl. health sci. 2018; 4(1): 15-27 16 Urbič Jurak P. et al. Organ Donation: Experience in the Maintenance of a brain-Dead Donor. J. appl. health sci. 2018; 4(1): 15For the qualitative analysis [9][10] , semi-structured interviews were conducted with five sets of questions, summarized by a validated instrument 11 .Following validation, the research lasted from 1 October until 20 December 2014. The eligibility criteria required that the participants possessed adequate levels of education and that they were employed at the clinical departments where the study was carried out.The questionnaire consisted of 28 open-ended, one closed-ended and seven compound questions. Other data were demographic data, a set of statements regarding the individual's working environment, organ donation, feelings and work with dead donors, possible disburdening after the work and meetings with relatives. For some questions (numbers 5, 15, 23, 25) a validated instrument was used [12][13][14][15] . Some modifications of the questionnaire were necessary, due to clinical conditions. Out of 100 questionnaires, 75 were complet...

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“…Providing a clear definition of brain death and ensuring the family's understanding before organ donation is discussed are vital to avoid later misunderstanding. 89 Communication with family members after completion of a brain death protocol needs to be unequivocal that brain dead is dead. 89 The dead-donor rule requiring declaration of death before organ recovery for transplant can then apply.…”

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confidence: 99%

“…89 Communication with family members after completion of a brain death protocol needs to be unequivocal that brain dead is dead. 89 The dead-donor rule requiring declaration of death before organ recovery for transplant can then apply. 90 Bedside clinicians must maintain frequent monitoring, begin preparatory steps for clinical examinations called for in a brain death protocol, and facilitate safe transport for neurodiagnostic studies as appropriate.…”

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confidence: 99%

Brain Death: Assessment, Controversy, and Confounding Factors

Arbour

2013

Critical Care Nurse

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When brain injury is refractory to aggressive management and is considered nonsurvivable, with loss of consciousness and brain stem reflexes, a brain death protocol may be initiated to determine death according to neurological criteria. Clinical evaluation typically entails 2 consecutive formal neurological examinations to document total loss of consciousness and absence of brain stem reflexes and then apnea testing to evaluate carbon dioxide unresponsiveness within the brain stem. Confounding factors such as use of therapeutic hypothermia, high-dose metabolic suppression, and movements associated with complex spinal reflexes, fasciculations, or cardiogenic ventilator autotriggering may delay initiation or completion of brain death protocols. Neurodiagnostic studies such as 4-vessel cerebral angiography can rapidly document absence of blood flow to the brain and decrease intervals between onset of terminal brain stem herniation and formal declaration of death by neurological criteria. Intracranial pathophysiology leading to brain death must be considered along with clinical assessment, patterns of vital signs, and relevant diagnostic studies.

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Organ Donation : Intensive Care Issues in Managing Brain Dead

Cited by 5 publications

References 26 publications

Review 1: Lung transplant—from donor selection to graft preparation

Review 1: Lung transplant—from donor selection to graft preparation

Organ Donation: Experience in the Maintenance of a Brain-Dead Donor

Brain Death: Assessment, Controversy, and Confounding Factors

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