scholarly journals Anaesthetic management of the brain dead for organ donation

1990 ◽  
Vol 37 (7) ◽  
pp. 806-812 ◽  
Author(s):  
Adrian W. Gelb ◽  
Kerri M. Robertson
2019 ◽  
Vol 13 (4) ◽  
pp. 1124
Author(s):  
Aline Lima Pestana Magalhães ◽  
Roberta Juliane Tono de Oliveira ◽  
Saulo Fabio Ramos ◽  
Milene Mendes Lobato ◽  
Neide Da Silva Knihs ◽  
...  

RESUMO Objetivo: compreender a gerência do cuidado de enfermagem aos pacientes em morte encefálica na perspectiva de enfermeiros atuantes no processo de doação e transplantes de órgãos. Método: trata-se de estudo qualitativo, fundamentado na Teoria Fundamentada nos Dados, com 25 enfermeiras. Obtiveram-se os dados por meio de entrevistas semiestruturadas individuais e se empregou a codificação aberta, axial e seletiva para análise dos dados. Resultados: emergiram-se duas categorias a partir da análise dos dados: << Observando as dificuldades relacionadas a gerência do cuidado de enfermagem ao paciente em morte encefálica >> e << Compreendendo as ações realizadas pela equipe de enfermagem na gerência do cuidado ao paciente em morte encefálica >>. Destacaram-se como dificuldades a limitação da estrutura física, recursos humanos e materiais. Enfatizaram-se pelos enfermeiros a monitorização e o suporte hemodinâmico, controle glicêmico e de diurese como ações necessárias para a gerência do cuidado ao paciente em morte encefálica. Conclusão: compreende-se que a gerência do cuidado ao paciente em morte encefálica requer entendimento para além das esferas técnicas sendo necessária a desmistificação do significado da doação de órgãos para manutenção de uma nova vida em outro alguém. Descritores: Obtenção de Tecidos e Órgãos; Transplante de Órgãos; Cuidados de Enfermagem; Cuidados Críticos; Morte Encefálica; Papel do Profissional de Enfermagem.ABSTRACT Objective: to understand the management of Nursing care to patients in brain death from the perspective of nurses working in the process of organ donation and transplants. Method: this is a qualitative study, based on the Data Based Theory, with 25 nurses. The data were obtained through individual semi-structured interviews and the open, axial and selective coding was used for data analysis. Results: two categories emerged from the analysis of the data: "Observing the difficulties related to the management of nursing care to the brain dead patient" and "Understanding the actions performed by the nursing team in the management of the brain dead patient's care. The limitations of physical structure and human and material resources were highlighted as difficulties. Monitoring and hemodynamic support, glycemic control and diuresis as necessary actions for the management of patient care in brain death were emphasized by the nurses. Conclusion: it is understood that the management of patient care in brain death requires understanding beyond the technical spheres, and it is necessary to demystify the meaning of organ donation for the maintenance of a new life in another person. Descriptors: Tissue and Organ Procurement; Organ Transplantation; Nursing Care; Critical Care; Brain Death; Nurse’s Role.RESUMEN Objetivo: comprender la gestión del cuidado de enfermería a los pacientes en muerte encefálica en la perspectiva de enfermeros actuantes en el proceso de donación y trasplantes de órganos. Método: se trata de un estudio cualitativo, fundamentado en la Teoría Fundamentada en los Datos, con 25 enfermeras. Se obtuvieron los datos por medio de entrevistas semiestructuradas individuales y se empleó la codificación abierta, axial y selectiva para análisis de los datos. Resultados: surgieron dos categorías a partir del análisis de los datos: << Observando las dificultades relacionadas a la gestión del cuidado de enfermería al paciente en muerte encefálica >> y << Comprendiendo las acciones realizadas por el equipo de enfermería en la gestión del cuidado al paciente en muerte encefálica >>. Se destacaron como dificultades la limitación de la estructura física, recursos humanos y materiales. Se enfatizaron por los enfermeros el monitoreo y el soporte hemodinámico, control glucémico y de diuresis como acciones necesarias para la gestión del cuidado al paciente en muerte encefálica. Conclusión: se comprende que la gestión del cuidado al paciente en muerte encefálica requiere entendimiento más allá de las esferas técnicas siendo necesaria la desmitificación del significado de la donación de órganos para el mantenimiento de una nueva vida en otro. Descriptores: Obtención de Tejidos y Órganos; Trasplante de Órganos; Atención de Enfermería; Cuidados Críticos; Muerte Encefálica; Rol de la Enfermera.


2018 ◽  
Vol 8 (3-4) ◽  
pp. 167-178
Author(s):  
Piotr Grzegorz Nowak

Abstract Singer claims that there are two ways of challenging the fact that brain-dead patients, from whom organs are usually retrieved, are in fact biologically alive. By means of the first, the so called dead donor rule may be abandoned, opening the way to lethal organ donation. In the second, it might be posited that terms such as “life” and “death” do not have any primary biological meaning and are applicable to persons instead of organisms. This second possibility permits one to acknowledge that brain-dead patients are deceased because they are irreversibly unconscious. In the commentary which follows, I will argue that Singer’s second option is preferable since it (a) provides a higher amount of organs available for transplant, and (b) is better suited to the meaning of “death” which occurs in ordinary language. I will also defend such a concept of death against the objections raised by Michael Nair-Collins in the article Can the brain-dead be harmed or wronged? On the moral status of brain death and its implications for organ transplantation.


2013 ◽  
Vol 28 ◽  
pp. 1
Author(s):  
H. Hoseinrezaee ◽  
A. Mehdizadeh Zare Anari ◽  
M. Pilevarzadeh ◽  
N. Khanjani ◽  
F. Najmie Nouri ◽  
...  

1990 ◽  
Vol 34 (7) ◽  
pp. 592-595 ◽  
Author(s):  
T. Randell ◽  
R. Orko ◽  
K. Höckerstedt

2011 ◽  
Vol 11 (10) ◽  
pp. 2247-2249 ◽  
Author(s):  
W. G. Sui ◽  
Q. Yan ◽  
S. P. Xie ◽  
H. Z. Chen ◽  
D. Li ◽  
...  

2010 ◽  
Vol 19 (5) ◽  
pp. e52-e61 ◽  
Author(s):  
Liva Jacoby ◽  
James Jaccard

BackgroundFamilies’ experiences in the hospital influence their decisions about donating organs of brain-dead relatives. Meeting families’ support needs during this traumatic time is an obligation and a challenge for critical care staff.Objectives(1) To elicit family members’ accounts of various types of support received and perceived quality of care for themselves and their loved ones when they made the donation decision, and (2) to examine the relationship between these factors and the families’ donation decision.MethodsRetrospective telephone interviews of 199 families from different regions of the country were completed. Aside from demographic data, the survey addressed perceptions of informational, emotional, and instrumental support and quality of care.ResultsOne hundred fifty-four study participants consented to donation; 45 declined. White next of kin were significantly more likely than African Americans to consent. Specific elements of reported support were significantly associated with consent to donate. Donor and nondonor families had differing perceptions of quality care for themselves and their loved ones. Receiving understandable information about organ donation was the strongest predictor of consent.ConclusionsSpecific supportive behaviors by staff as recounted by family members of potential donors were significantly associated with consent to donation. These behaviors lend themselves to creative training and educational programs for staff. Such interventions are essential not only for next of kin of brain-dead patients, but also for staff and ultimately for the public as a whole.


2018 ◽  
Author(s):  
Thomas I. Cochrane

Brain death is the state of irreversible loss of the clinical functions of the brain. A patient must meet strict criteria to be declared brain dead. They must have suffered a known and demonstrably irreversible brain injury and must not have a condition that could render neurologic testing unreliable. If the patient meets these criteria, a formal brain death examination can be performed. The three findings in brain death are coma or unresponsiveness, absence of brainstem reflexes, and apnea. Brain death is closely tied to organ donation, because brain-dead patients represent approximately 90% of deceased donors and thus a large majority of donated organs. This review details a definition and overview of brain death, determination of brain death, and controversy over brain death, as well as the types of organ donation (living donation versus deceased donation), donation after brain death, and donation after cardiac death. A figure presents a comparison of organ donation after brain death and after cardiac death, and a table lists the American Academy of Neurology Criteria for Determination of Brain Death. This review contains 1 highly rendered figure, 3 table, and 20 references.


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