Are terminally ill patients dying in the ICU suitable for non-heart beating organ donation?

Intensive Care Medicine
Jean-Pierre RevellyRené Chioléro

Abstract

To evaluate the feasibility of implementing a program of controlled non-heart beating organ donation, in patients undergoing the withdrawal of intensive care treatment. Prospective observational study. Medical and Surgical ICUs in a tertiary university hospital. Consecutive patients younger than 70 years dying in the ICU after treatment withdrawal for dire neurological prognosis. We analyzed prospectively collected data from the ICU clinical information system. Seventy-three of 516 ICU deaths (13%) were identified, equally distributed among traumatic, stroke, and anoxic brain injury. The management and the course in these three diagnostic categories were similar. All patients underwent withdrawal of mechanical ventilation and half were extubated. Median time to death was of 4.8 h (IQR 1.4-11.5). In 70% of cases the patient received analgesia and 30% sedation. Such treatment was not related to earlier death. Hypotension was observed in 50% of patients during the 30 min preceding cardiac death. With our current management of terminal patients controlled non-heart beating organ procedure may be difficult due to the duration and variability of the dying process. This observation suggests that we can perform better by evaluating thi...Continue Reading

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Citations

Jul 28, 2010·Intensive Care Medicine·Joseph L Verheijde, Mohamed Y Rady
Jun 2, 2012·The American Journal of Bioethics : AJOB·Thomas M WertinJoseph L Verheijde
May 24, 2007·Philosophy, Ethics, and Humanities in Medicine : PEHM·Joseph L VerheijdeJoan McGregor
Oct 6, 2006·Critical Care : the Official Journal of the Critical Care Forum·Mohamed Y RadyJoan McGregor
Nov 10, 2011·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Paul M ShoreLisa Thompson
May 28, 2014·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Nicole L Coleman, Ann Bonner
Feb 15, 2015·Journal of Intensive Care Medicine·Amanda van BeinumSonny Dhanani
Jul 24, 2008·Journal of Intensive Care Medicine·Mohamed Y RadyJoan McGregor
Aug 18, 2020·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Francisco Santos DiasRoberto Roncon-Albuquerque

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