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Transplant Proc ; 44(8): 2260-7, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23026569

RESUMEN

INTRODUCTION: The organ shortage for transplantation, the principal factor that increases waiting lists, has become a serious public health problem. In this scenario, the intensivist occupies a prominent position as one of the professionals that first has a chance to identify brain death and to be responsible for the maintenance of the potential deceased donor. OBJECTIVE: This report attempts to establish guidelines for care and maintenance of adult deceased donor organs guiding and standardizing care provided to patients with brain death. METHOD: These guidelines were composed by intensivists, transplant coordinators, professionals from various transplant teams, and used transplant center. The formulated questions were forwarded to all members and recommendations were constructed after an extensive literature review selecting articles with the highest degree of evidence. RESULTS: Guidelines were developed in the form of questions reflecting frequent experiences in clinical intensive care practices. The main questions were: Is there an optimal interval for keeping organs of deceased donors viable? What actions are considered essential for maintaining deceased donors in this period? What are the limits of body temperature? How should the patient be warmed? Which laboratory tests should be performed? What is the collection interval? What are the limits in the laboratory and the capture scenario? What are the limits of blood pressure? When and how should one use catecholamines? CONCLUSIONS: This pioneer project involved a multidisciplinary team working in organ transplantation seeking to provide treatment guidance to increase the number of viable organs from deceased adult donors.


Asunto(s)
Muerte Encefálica , Cuidados Críticos/normas , Trasplante de Órganos/normas , Donantes de Tejidos/provisión & distribución , Recolección de Tejidos y Órganos/normas , Obtención de Tejidos y Órganos/normas , Adulto , Biomarcadores/sangre , Presión Sanguínea , Determinación de la Presión Sanguínea/normas , Volumen Sanguíneo , Temperatura Corporal , Muerte Encefálica/sangre , Muerte Encefálica/diagnóstico , Muerte Encefálica/fisiopatología , Brasil , Dióxido de Carbono/sangre , Cardiotónicos/uso terapéutico , Ecocardiografía/normas , Transfusión de Eritrocitos/normas , Medicina Basada en la Evidencia , Fluidoterapia/normas , Humanos , Presión Intracraneal , Ácido Láctico/sangre , Oxígeno/sangre , Recalentamiento/normas , Factores de Tiempo , Supervivencia Tisular , Vasoconstrictores/uso terapéutico
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