Brain Death Diagnosis for Potential Organ Donors During the Covid-19 Pandemic

2021 ◽  
Vol 69 (4) ◽  
pp. 995
Author(s):  
GirijaP Rath ◽  
Siddharth Chavali ◽  
Deep Sengupta ◽  
SuryaK Dube
2018 ◽  
Vol 102 ◽  
pp. S61
Author(s):  
Beatriz Mahillo ◽  
Esther Bernabe ◽  
Rocio Vega ◽  
Elisabeth Coll ◽  
Beatriz Domínguez-Gil

PEDIATRICS ◽  
1989 ◽  
Vol 83 (2) ◽  
pp. A42-A42
Author(s):  
Student

[There are] two policy choices: we can abandon attempts to justify use of anencephalic infants as organ donors because there is currently no clinically accepted means to declare brain death in these infants; or we can carry out the research necessary to establish a clinically valid procedure for doing so. A Canadian group has decided to take the second route and experiment on methods to use as organ donors anencephalic newborns who can be validly declared brain-dead on classic criteria. The group has developed a basic protocol that calls for the parents to agree, prior to birth, that: (1) the infant will be resuscitated; (2) periodic testing will be done to determine brain death (removal from the ventilator at six-to-twelve-hour intervals for a ten-minute period to determine ability to breathe spontaneously; (3) organ donation is acceptable; and (4) a definite time limit (to be determined by the parents but not more than fourteen days) after which the infant will be removed from the ventilator and permitted to die. Low-dose morphine is administered to prevent potential suffering on the part of the infant, although whether anencephalic newborns can suffer is unknown.


2015 ◽  
Vol 8 (7) ◽  
pp. 281 ◽  
Author(s):  
Zahra Keshtkaran ◽  
Farkhondeh Sharif ◽  
Elham Navab ◽  
Sakineh Gholamzadeh

<p><strong>BACKGROUND: </strong>Brain death is a concept in which its criteria have been expressed as documentations in Harvard Committee of Brain Death. The various perceptions of caregiver nurses for brain death patients may have effect on the chance of converting potential donors into actual organ donors.</p><p>Objective: The present study has been conducted in order to perceive the experiences of nurses in care-giving to the brain death of organ donor patients.</p><p><strong>METHODS:</strong> This qualitative study was carried out by means of Heidegger’s hermeneutic phenomenology. Eight nurses who have been working in ICU were interviewed. The semi-structured interviews were recorded bya tape-recorder and the given texts were transcribed and the analyses were done by Van-Mannen methodology and (thematic) analysis.</p><p><strong>RESULTS: </strong>One of the foremost themes extracted from this study included ‘Halo of ambiguity and doubt’ that comprised of two sub-themes of ‘having unreasonable hope’ and ‘Conservative acceptance of brain death’. The unreasonable hope included lack of trust (uncertainty) in diagnosis and verification of brain death, passing through denial wall, and avoidance from explicit and direct disclosure of brain death in patients’ family. In this investigation, the nurses were involved in a type of ambiguity and doubt in care-giving to the potentially brain death of organ donor patients, which were also evident in their interaction with patients’ family and for this reason, they did not definitely announce the brain death and so far they hoped for treatment of the given patient. Such confusion and hesitance both caused annoyance of nurses and strengthening the denial of patients’ family to be exposed to death.</p><p><strong>CONCLUSION:</strong> The results of this study reveal the fundamental perceived care-giving of brain death in organ donor patients and led to developing some strategies to improve care-giving and achievement in donation of the given organ and necessity for presentation of educational and supportive services for nurses might become more evident than ever.</p>


2018 ◽  
Vol 39 (5) ◽  
pp. 515-529 ◽  
Author(s):  
Tanvir Rizvi ◽  
Prem Batchala ◽  
Sugoto Mukherjee

2021 ◽  
Author(s):  
Tomasz Dawiskiba ◽  
Wojciech Wojtowicz ◽  
Badr Qasem ◽  
Marceli Łukaszewski ◽  
Karolina Anna Mielko ◽  
...  

Abstract There is a clear difference between severe brain damage and brain death. However, in clinical practice, the differentiation of these states can be challenging. Currently, there are no laboratory tools that facilitate brain death diagnosis. The aim of our study was to evaluate the utility of serum metabolomic analysis in differentiating coma patients (CP) from individuals with brain death (BD). Serum samples were collected from 23 adult individuals with established diagnosis of brain death and 24 patients in coma with Glasgow Coma Scale 3 or 4, with no other clinical symptoms of brain death for at least 7 days after sample collection. Serum metabolomic profiles were investigated using proton nuclear magnetic resonance (NMR) spectroscopy. The results obtained were examined by univariate and multivariate data analysis (PCA, PLS-DA, and OPLS-DA). Metabolic profiling allowed us to quantify 43 resonance signals, of which 34 were identified. Multivariate statistical modeling revealed a highly significant separation between coma patients and brain-dead individuals, as well as strong predictive potential. The findings not only highlight the potential of the metabolomic approach for distinguishing patients in coma from those in the state of brain death but also may provide an understanding of the pathogenic mechanisms underlying these conditions.


Author(s):  
Kelser De Souza Kock ◽  
Mariana Gabriela Santana ◽  
Silvia Catarine Da Silva ◽  
Samuel Brida Andrade ◽  
Edvan Nunes dos Santos

Objetivo: Analisar o perfil epidemiológico e as disfunções orgânicas e eletrolíticas em potenciais doadores de órgãos. Métodos: Estudo transversal, descritivo. Foram selecionados pacientes com morte encefálica, na Unidade de Terapia Intensiva de um hospital do sul do estado de Santa Catarina, no período de 2014 a 2016. Resultados: Foram avaliados 64 indivíduos, com prevalência do sexo masculino (56,3%), com mediana de 51,5 anos de idade. O Acidente Vascular Cerebral mostrou-se como a principal causa de diagnóstico de morte encefálica, em 42% dos casos. Houve doação em 45% dos pacientes, totalizando 120 órgãos ou tecidos doados, destacando-se o globo ocular, os rins e o fígado. Nos exames laboratoriais os pacientes apresentaram uma mediana de 147,0 mmol/L para o sódio, 4,2 mmol/L para o potássio e 246,0 mg/dL para a glicose. O escore de SOFA apresentou mediana geral 6, com maiores valores nos SOFA cardiovascular e respiratório (p<0,001) em relação aos SOFA renal, hematológico e hepático. Conclusão: O perfil epidemiológico dos potenciais doadores é similar a outros estudos. Quanto às disfunções orgânicas eletrolíticas e metabólicas, foram evidenciados distúrbios de hipernatremia e hiperglicemia. As disfunções orgânicas significativas identificadas pelo SOFA foram nos sistemas cardiovascular e respiratório. Neste sentido, especial atenção deve ser dada a estes sistemas para adequada manutenção do potencial doador.Descritores: Morte encefálica, Obtenção de tecidos e órgãos, Eletrólitos, Escores de disfunção orgânicaABSTRACT:Objective: To analyze the epidemiological profile and the organ and electrolytics dysfunctions in potential organ donors. Methods: Cross-sectional, descriptive study. We selected patients with brain death at the Intensive Care Unit of a hospital in the southern state of Santa Catarina, from 2014 to 2016. Results: We evaluated sixty-six individuals, with a prevalence of males (56.3%), with a median age of 51.5 years. The Cerebral Vascular Accident was the main cause of brain death’s diagnosis (42%). There was donation in 45% of the patients, totaling 120 organs and tissue donated, standing out the eyeball, kidneys and liver. In the laboratory tests the patients had a median of 147.0 mmol / L for sodium, 4.2 mmol / L for potassium and 246.0 mg / dL for glucose. The SOFA score presented general median 6, with higher values in cardiovascular and respiratory SOFA (p <0.001) in relation to renal, hematological and hepatic SOFA. Conclusion: The epidemiological profile of potential donors is similar to other studies. As for the organic and metabolic dysfunctions, disorders of hypernatremia and hyperglycemia were evidenced. The significant organic dysfunctions identified by SOFA were in the cardiovascular and respiratory systems. In this sense, special attention should be given to these systems for adequate maintenance of the potential donor.Keywords: Brain death, Tissue and organ procurement, Electrolytes, Organ dysfunction scores


2019 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Savaş Altınsoy ◽  
Elif Şule Özdemir ◽  
İlkay Baran ◽  
Fatma Kavak Akelma ◽  
Mukaddes Tuğba Arslan ◽  
...  

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