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Canadian Journal of Anaesthesia

, Volume 37, Issue 7, pp 806–812 | Cite as

Anaesthetic management of the brain dead for organ donation

  • Adrian W. Gelb
  • Kerri M. Robertson
Continuing Medical Education

Abstract

An increasing number of anaesthetists is being called upon to manage organ donors during organ retrieval procedures. We briefly describe the technical aspects of the surgical procedure together with a guide to the anaesthetic management. The aims of the latter may be summarized as the “Rule of 100”: systolic blood pressure > 100 mmHg, urine output > 100 ml · hr−1, PaO2 > 100 mmHg, haemoglobin concentration > 100 g · L−1. Common management problems hypotension, arrhythmias, diabetes insipidus, oliguria, and coagulopathy) are discussed in detail. The intraoperative management of the brain-dead organ donor provides the anaesthetist with the challenge of a major surgical procedure in a subject with important physiological derangements.

Key words

anaesthesia: transplantation brain: death 

Résumé

Les anesthésistes sont appelés de plus en plus à devoir s’occuper cles « donneurs » d’organes durant l’opération de prélèvement. Nous décrivons brièvement la technique chirurgicale et proposons un plan d’action pour l’anesthésiste. On peut simplifier en lui proposant de s’en tenir a la «règie des 100»: tension artérielle systolique > 100 mmHg, débit urinaire > 100 ml · h−1, PaO2 > 100 mmHg, hémoglobine > 100 g · L−1. Nous revoyons aussi le traitement des; problemes les plus fréquents: hypotension, arythmie, diabète insipide, oligurie et coagulopathie. Le prélèvement d’organe après mort cérébrate pose à l’anesthésiste, le défi d’une intervention chirurgicale majeure chez un sujet à la physiologie altérée.

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Copyright information

© Canadian Anesthesiologists 1990

Authors and Affiliations

  • Adrian W. Gelb
    • 1
  • Kerri M. Robertson
    • 2
  1. 1.Department of AnaesthesiaUniversity HospitalLondonCanada
  2. 2.Department of AnesthesiaUniversity of Mississippi Medical CentreJackson

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