2017
DOI: 10.29046/jhnj.012.1.007
|View full text |Cite
|
Sign up to set email alerts
|

Declaring Brain Death on ECMO

Abstract: Purpose: Accumulating evidence suggests that organs from ECMO patients can be safely transplanted after a declaration of cardiac or brain death. However, making a diagnosis of brain death while a patient is on ECMO poses unique challenges and limited literature exists. We sought to describe the practice variations involved with declaring patients brain dead on ECMO by reviewing charts from our local organ procurement organization.Methods: After institutional review board approval, a retrospective chart review … Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...
3
1

Citation Types

0
6
0

Year Published

2017
2017
2023
2023

Publication Types

Select...
3
1

Relationship

0
4

Authors

Journals

citations
Cited by 4 publications
(6 citation statements)
references
References 20 publications
(24 reference statements)
0
6
0
Order By: Relevance
“…One study corroborates this lack of consensus regarding defining brain death in a patient on ECMO (Kreitler et al 2015). This uncertainty further contributes to moral distress:

“…I think what probably bothered everybody most…is that final 48 hours where we took it too far, that we didn’t call it sooner.

…”
mentioning
confidence: 77%
“…One study corroborates this lack of consensus regarding defining brain death in a patient on ECMO (Kreitler et al 2015). This uncertainty further contributes to moral distress:

“…I think what probably bothered everybody most…is that final 48 hours where we took it too far, that we didn’t call it sooner.

…”
mentioning
confidence: 77%
“…AT is considered negative if there is an observed respiratory movement either visualized during the test, detected by ventilator, or by evidence of thoraco-abdominal de-synchrony in consolidated lungs with poor thoracic compliance. It is abandoned in cases of development of hypoxia or deranged hemodynamics [3,7].…”
Section: Discussionmentioning
confidence: 99%
“…Hepatic and renal dysfunction may further delay the drug clearance. Gaseous exchange across the membrane depends on sweep gas flow, the differential movement of carbon dioxide and oxygen, and differential solubility, and hence, the adequate increase in CO 2 either does not occur or takes prolonged period which are complicated by hypoxia or hemodynamic alterations [3,7,8]. Hence, on ECMO, the recommended value of PaCO 2 rise for a confirmatory AT may not occur even after the stipulated time of AT of 8 to 10 min.…”
Section: Discussionmentioning
confidence: 99%
See 2 more Smart Citations