scholarly journals How large is the organ donor potential in Germany? Results of an analysis of data collected on deceased with primary and secondary brain damage in intensive care unit from 2002 to 2005

2007 ◽  
Vol 20 (2) ◽  
Author(s):  
Claus Wesslau ◽  
Katharina Grosse ◽  
Ronald Krüger ◽  
Onur Kücük ◽  
Dietmar Mauer ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Damage ◽  
Organ Donor ◽  
Secondary Brain Damage

scholarly journals The role of indirect calorimetry in the treatment and rehabilitation of patients in long-term unconsciousness after brain damage

2020 ◽  
Vol 1 (1) ◽  
pp. 10-16
Author(s):  
Kirill Yu. Krylov ◽  
Ivan V. Sergeev ◽  
Alexandra V. Yakovleva ◽  
Ruben S. Yagubyan ◽  
Alexey A. Yakovlev ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Energy Expenditure ◽  
Brain Damage ◽  
Indirect Calorimetry ◽  
Critically Ill Patients ◽  
Nutritional Support ◽  
Nitrogen Loss ◽  
Energy Requirements

Background. Nutritional support is an important part of the treatment of critically ill patients. However, there are no specific recommendations for patients in a long unconscious state after brain damage to determine their energy needs. Aim. To determine the role of indirect calorimetry in assessing the energy expenditure of patients in prolonged unconsciousness after brain damage. Methods. Prospective cohort study included 81 patients with brain damage who were treated in the intensive care unit. All patients with prolonged unconsciousness had stayed in the intensive care unit for more than 30 days. Mean age of patients was 48.4 16.3 years. Men were predominant (58%). Almost all patients had normal body mass index (BMI) (mean 22.8 6.2 kg/m2). The main cause of brain damage was severe traumatic injury (42%). There were also patients with consequences of subarachnoid hemorrhage (35%), stroke (19%) and hypoxic damage (4%). Results. According to indirect calorimetry, mean energy requirements in patients in prolonged unconsciousness was 25.12 8.8 kcal/kg/day (1595.3 560 kcal/day). Variability of this value was high in this sample (10.661.6 kcal/kg/day, 6733514 kcal/day). According to urine nitrogen loss, mean protein requirement was 0.83 0.46 g/kg/day that was lower than the recommended values for critically ill patients. Variability of data obtained by indirect calorimetry was higher than that of the calculated values despite statistically similar energy requirements of patients. Variability of data obtained by Harris-Benedict equation ranged from 15.4 kcal/kg/day (1023 kcal/day) to 37.3 kcal/kg/day (2065 kcal/day). There was no relationship between energy expenditure and causes of brain damage. Moreover, significant correlation between metabolic rate, urine nitrogen loss and outcomes of disease was also absent. Conclusion. Indirect calorimetry alone is not enough to prescribe optimal nutritional support in patients with prolonged unconsciousness if function of the gastrointestinal tract and other factors affecting energy expenditure are not considered.

scholarly journals Stressors in the nursing care delivered to potential organ donors

2009 ◽  
Vol 17 (6) ◽  
pp. 1023-1029 ◽  
Author(s):  
Laura de Azevedo Guido ◽  
Graciele Fernanda da Costa Linch ◽  
Rafaela Andolhe ◽  
Carmine Cony Conegatto ◽  
Carolina Codevila Tonini
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nursing Care ◽  
Organ Donor ◽  
Physical Activities ◽  
Organ Donors ◽  
Tissue Donors ◽  
Adult Intensive Care Unit ◽  
Potential Organ Donor ◽  
Self Confidence

This study examines those situations that are typical to the work of the nursing team in the intensive care unit, especially those that nursing teams consider stressful and are common in intensive care units in the treatment of patients being considered as potential organ or tissue donors. It is an exploratory-descriptive study, established with a qualitative approach, conducted at an Adult Intensive Care Unit. The reports revealed the fact that organ donation leads to different situations and emotions. Regarding the perception of nursing care to the potential organ donor patient, the subjects reported they did not discriminate patients when delivering care, but recognize a certain lack of self-confidence and preparation dealing with brain death. They try to minimize the effects of stressors with physical activities, social support, spirituality, or attempt to separate work from personal life.

scholarly journals Care With The Potential Organ Donor In The Intensive Care Unit

10.3823/2306 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Francisca Patrícia Barreto de Carvalho ◽  
Kênnia Stephanie Morais Oliveira ◽  
Glauber Weder Dos Santos Silva ◽  
Geórgia Nóbrega Melo ◽  
Thiago Enggle de Araújo Alves ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Donor ◽  
Qualitative Approach ◽  
Pertinent Literature ◽  
Potential Donor ◽  
Potential Organ Donor ◽  
Material Resources ◽  
Organ Harvesting ◽  
Specific Care

Introduction: Organ transplants have expanded throughout the country, being extremely significant for the population. Objective: To know the reality of organ harvesting and describe the care with the potential organ donor in an Intensive Care Unit (ICU) and compare it with the pertinent literature. Method: It is a research of exploratory and descriptive nature, with a qualitative approach. The data were analyzed through the content analysis idealized by Bardin. Results: The findings indicate that the resolution of care and procedures with the potential donor is essential to the success of transplants in our country. Conclusions: Several difficulties have been encountered, as the lack of human and material resources generating impasses in the specific care of the potential organ donor and the lack of provision of continuing education. Keywords: Organ donation; Intensive Care Unit; Nursing.

scholarly journals Management of Status Epilepticus

1998 ◽  
Vol 25 (S1) ◽  
pp. S4-S6 ◽  
Author(s):  
Michael J. Aminoff
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Status Epilepticus ◽  
General Anesthesia ◽  
Brain Damage ◽  
Response To Treatment ◽  
Motor Activities ◽  
Pharmacologic Management ◽  
Convulsive Seizures ◽  
Electroencephalogram Eeg

AbstractThe pharmacologic management of major motor status epilepticus is summarized. When general anesthesia is required, the electroencephalogram (EEG) is used for monitoring the adequacy of treatment. The EEG findings may also be important in recognizing status epilepticus and monitoring its response to treatment when this is clinically difficult, as when it occurs in comatose or pharmacologically paralyzed patients or in the context of severe brain damage. Finally, the EEG helps to clarify the nature of motor activities of uncertain basis in patients in the intensive care unit and has indicated that non-convulsive seizures or status are more common than clinically suspected in such patients.

scholarly journals Features of electrophysiological activity in a neonate with severe post-hypoxic brain damage (post-hypoxic cerebral depression)

2020 ◽  
Vol 11 (6) ◽  
pp. 13-20
Author(s):  
Tatiana V. Melashenko ◽  
Maria Y. Fomina ◽  
Alexander B. Palchik ◽  
Olga I. Pavlova
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Damage ◽  
Neonatal Intensive Care ◽  
Hypoxic Brain Damage ◽  
Hypoxic Brain ◽  
Central Nervous System Depression ◽  
Neuroimaging Data ◽  
Alpha Coma ◽  
Visual Diagnosis

The article briefly presents the literature data and a description of the clinical dynamic observation of a patient with severe hypoxic brain damage (from the neonatal period to 4 months of life), in the conditions of the neonatal intensive care unit. The article describes the clinical picture, features of paroxysmal states and antiepileptic therapy, dynamics of neuroimaging data, electroencephalographic phenomena recorded in a patient with cerebral depression and structural cerebral injuries. The significance of electroencephalographic examination in the intensive care unit as an informative method for assessing cerebral activity in young children with central nervous system depression syndrome is shown. Disorganization of background activity, indicating structural cerebral damage, long-term persistence of slow-wave activity, detection of epileptic changes in the form of generalized flashes of pointed waves in the theta range, alpha-coma pattern, subsequently replaced by suppression of the background pattern in the patient, are typical electrophysiological disorders recorded in severe hypoxic encephalopathy. In conditions of limited opportunities for visual diagnosis of a patient with impaired consciousness, EEG remains the only method of obtaining information about the functional state of the brain, the data obtained during the study are an important prognostic criterion.

scholarly journals Caring for a potential organ donor at an intensive care unit: the role of the nurse

2017 ◽  
Vol 11 (2) ◽  
pp. 35-39
Author(s):  
Sylwia Kosek ◽  
Anna Klimczyk
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Death ◽  
Organ Donor ◽  
Loss Of Function ◽  
Potential Organ Donor ◽  
Difficult Conversations ◽  
The Family ◽  
The Individual

Brain death causes irreparable loss of function of the brain as whole and is tantamount to the individual death. According to the governing laws in Poland, a committee composed of three consultants, including a specialist in anaesthesiology and intensive care and a specialist in neurosurgery or neurology, states the individual death. Stating brain death has occurred discharges doctors from their obligation to continue therapy. In the event the organs can be harvested for transplant, after ruling out the objection of the deceased and medical counter indications, medical staff continues to care for the donor during the period of preliminary observation, diagnostics and establishing brain death, and later for the deceased, until the organs are harvested. It includes all activities, from monitoring to therapy, diagnostic and nursing activities. Nurses play an important role in the team providing care to a donor. The nurse should have extensive knowledge about brain death, its course and results, as they play an important role in proper diagnostic procedure and providing proper care until the organs are harvested. Strict nursing supervision of the donor allows the staff to detect deviations in the functioning of the organism early. The aim of this paper was to present the procedures concerning declaring brain death and portraying the role of a nurse in caring for a potential organ donor at an intensive care unit. Conclusions. Proper procedure is paramount in harvesting good quality organs for transplantation and assuring their proper functioning later. It is worthwhile to note the role of the nurse in contacts with the family, as cooperation with the donor’s family is an important aspect of the process, especially the ability to conduct difficult conversations.

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