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.
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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Gelb, A.W., Robertson, K.M. Anaesthetic management of the brain dead for organ donation. Can J Anaesth 37, 806–812 (1990). https://doi.org/10.1007/BF03006543
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DOI: https://doi.org/10.1007/BF03006543