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Titolo:
Observations of withdrawal of life-sustaining treatment from patients who became non-heart-beating organ donors
Autore:
DeVita, MA; Snyder, JV; Arnold, RM; Siminoff, LA;
Indirizzi:
Univ Pittsburgh, Med Ctr, Dept Anesthesiol Crit Care Med, Pittsburgh, PA 15213 USA Univ Pittsburgh Pittsburgh PA USA 15213 are Med, Pittsburgh, PA 15213 USA Univ Pittsburgh, Med Ctr, Dept Internal Med, Pittsburgh, PA 15213 USA UnivPittsburgh Pittsburgh PA USA 15213 nal Med, Pittsburgh, PA 15213 USA Univ Pittsburgh, Med Ctr, Inst Qaul & Med Management, Pittsburgh, PA 15260USA Univ Pittsburgh Pittsburgh PA USA 15260 nagement, Pittsburgh, PA 15260USA Case Western Reserve Univ, Cleveland, OH 44106 USA Case Western Reserve Univ Cleveland OH USA 44106 Cleveland, OH 44106 USA
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 6, volume: 28, anno: 2000,
pagine: 1709 - 1712
SICI:
0090-3493(200006)28:6<1709:OOWOLT>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSPLANTATION; EXPERIENCE; LIVER;
Keywords:
organ procurement; cadaver; transplantation; ethics; life support care; tissue donors; terminal care; brain death; informed consent;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
18
Recensione:
Indirizzi per estratti:
Indirizzo: DeVita, MA Univ Pittsburgh, Med Ctr, Dept Anesthesiol Crit Care Med, C111 PUH,200 Lothrop St, Pittsburgh, PA 15213 USA Univ Pittsburgh C111 PUH,200 Lothrop St Pittsburgh PA USA 15213
Citazione:
M.A. DeVita et al., "Observations of withdrawal of life-sustaining treatment from patients who became non-heart-beating organ donors", CRIT CARE M, 28(6), 2000, pp. 1709-1712

Abstract

Objective: Non-heart-beating organ donation for transplantation is increasing despite the concern whether all the donors are dead. This concern is based on the adequacy of documentation of death and the appropriate duration that circulation and respiration should be absent before death certification. No studies have examined the documentation and deaths of patients who became non-heart-beating organ donors. Design: Retrospective study of observational data. Patients: All non-brain-dead patients who became non-heart-beating organ donors at the University of Pittsburgh Medical Center from January 1, 1993, to June 30, 1998, were identified. Records for 15 of 16 patients were available for review. Measurements and Main Results:Adequacy of documentation, extubation time, onset of severe hypotension, duration of absent circulation before death was certified, and the time of incision for organ procurement were ascertained. Twelve of 15 records had all required clinical documentation. The mean age of patients was 46.5 +/- 5.7 yrs. All 15 patients were extubated before death and had femoral arterial catheters; one had a biventricular assist device discontinued. The time of hypotension and pulselessness was not documented for one and three patients, respectively. All 12 patients with documentation had greater than or equal to 2 mins of absent circulation. Time fromcertification to incision for procurement was 1.1 +/- 2.3 mins. Conclusions: In a small study of non-heart-beating organ donation, circulation never resumed after >1 min of absent circulation, suggesting that 2 mins of absent circulation is sufficient to certify death. Three of 15 patients had inadequate documentation. Gaps and inconsistencies in documentation may raise concern about the potential for abuse.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/10/20 alle ore 04:52:25