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.
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.
Authors: S Sudhindran; G J Pettigrew; A Drain; M Shrotri; C J E Watson; N V Jamieson; J A Bradley Journal: Clin Transplant Date: 2003-04 Impact factor: 2.863
Authors: Jean-Pierre Revelly; Luca Imperatori; Philippe Maravic; Marie-Denise Schaller; René Chioléro Journal: Intensive Care Med Date: 2006-03-14 Impact factor: 17.440
Authors: Charles L Sprung; Simon L Cohen; Peter Sjokvist; Mario Baras; Hans-Henrik Bulow; Seppo Hovilehto; Didier Ledoux; Anne Lippert; Paulo Maia; Dermot Phelan; Wolfgang Schobersberger; Elisabet Wennberg; Tom Woodcock Journal: JAMA Date: 2003-08-13 Impact factor: 56.272
Authors: Peter Andrews; Elie Azoulay; Massimo Antonelli; Laurent Brochard; Christian Brun-Buisson; Daniel De Backer; Geoffrey Dobb; Jean-Yves Fagon; Herwig Gerlach; Johan Groeneveld; Duncan Macrae; Jordi Mancebo; Philipp Metnitz; Stefano Nava; Jerôme Pugin; Michael Pinsky; Peter Radermacher; Christian Richard Journal: Intensive Care Med Date: 2006-12-19 Impact factor: 17.440
Authors: Jean-Pierre Revelly; Luca Imperatori; Philippe Maravic; Marie-Denise Schaller; René Chioléro Journal: Intensive Care Med Date: 2006-03-14 Impact factor: 17.440