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

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Serval ID
serval:BIB_BA0BD07C857F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Are terminally ill patients dying in the ICU suitable for non-heart beating organ donation?
Journal
Intensive Care Medicine
Author(s)
Revelly  J. P., Imperatori  L., Maravic  P., Schaller  M. D., Chiolero  R.
ISSN
0342-4642 (Print)
Publication state
Published
Issued date
05/2006
Volume
32
Number
5
Pages
708-12
Notes
Journal Article --- Old month value: May
Abstract
OBJECTIVE: To evaluate the feasibility of implementing a program of controlled non-heart beating organ donation, in patients undergoing the withdrawal of intensive care treatment. DESIGN AND SETTING: Prospective observational study. Medical and Surgical ICUs in a tertiary university hospital. PATIENTS: Consecutive patients younger than 70 years dying in the ICU after treatment withdrawal for dire neurological prognosis. MEASUREMENTS AND RESULTS: 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. CONCLUSIONS: 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 this process more closely.
Keywords
Aged *Heart Humans *Intensive Care Units Middle Aged Prospective Studies Switzerland *Terminally Ill *Tissue and Organ Procurement Withholding Treatment
Pubmed
Web of science
Open Access
Yes
Create date
24/01/2008 17:03
Last modification date
01/10/2019 6:19
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