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"Brain death"

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https://www.readbyqxmd.com/read/28323775/inadequate-antioxidative-responses-in-kidneys-of-brain-dead-rats
#1
Dane Hoeksma, Rolando A Rebolledo, Maximilia Hottenrott, Yves S Bodar, Janneke J Wiersema-Buist, Harry Van Goor, Henri G D Leuvenink
BACKGROUND: Brain death (BD)-related lipid peroxidation, measured as serum malondialdehyde (MDA) levels, correlates with delayed graft function in renal transplant recipients. How BD affects lipid peroxidation is not known. The extent of BD-induced organ damage is influenced by the speed at which intracranial pressure increases. To determine possible underlying causes of lipid peroxidation, we investigated the renal redox balance by assessing oxidative and antioxidative processes in kidneys of brain-dead rats after fast and slow BD induction...
April 2017: Transplantation
https://www.readbyqxmd.com/read/28320595/brain-death-during-pregnancy-and-prolonged-corporeal-support-of-the-body-a-critical-discussion
#2
Lynne Staff, Meredith Nash
AIM: To discuss corporeal support of the brain-dead pregnant woman and to critically examine important aspects of this complex situation that remain as yet unexplored. BACKGROUND: When brain death of the woman occurs during pregnancy, the fetus may be kept inside the corporeally supported body for prolonged periods to enable continued fetal growth and development. This has been increasingly reported in medical literature since 1982 and has received considerable media attention in the past few years...
March 17, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28318674/organ-donor-management-eight-common-recommendations-and-actions-that-deserve-reflection
#3
C Chamorro-Jambrina, M R Muñoz-Ramírez, J L Martínez-Melgar, M S Pérez-Cornejo
Despite major advances in our understanding of the physiopathology of brain death (BD), there are important controversies as to which protocol is the most appropriate for organ donor management. Many recent reviews on this subject offer recommendations that are sometimes contradictory and in some cases are not applied to other critically ill patients. This article offers a review of the publications (many of them recent) with an impact upon these controversial measures and which can help to confirm, refute or open new areas of research into the most appropriate measures for the management of organ donors in BD, and which should contribute to discard certain established recommendations based on preconceived ideas, that lead to actions lacking a physiopathological basis...
March 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28306594/extending-normothermic-regional-perfusion-to-the-thorax-in-donors-after-circulatory-death
#4
Steven S L Tsui, Gabriel C Oniscu
PURPOSE OF REVIEW: Despite a significant increase in the utilization of donors after circulatory death (DCD), the number of organs recovered and their function are largely inferior to those from donors after brain death. This review summarizes recent advances in in-situ normothermic regional perfusion of DCD organs prior to procurement. RECENT FINDINGS: The combination of warm and cold ischemia in DCD donation are detrimental to organ function. As a consequence, the acceptance criteria are far more restrictive and many organs are discarded...
March 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28304181/computed-tomography-angiography-as-a-confirmatory-test-for-the-diagnosis-of-brain-death
#5
Mark P Garrett, Richard W Williamson, Michael A Bohl, C Roger Bird, Nicholas Theodore
OBJECTIVE For a diagnosis of brain death (BD), ancillary testing is performed if patient factors prohibit a complete clinical examination and apnea test. The American Academy of Neurology (AAN) guidelines identify cerebral angiography (CA), cerebral scintigraphy, electroencephalography, and transcranial Doppler ultrasonography as accepted ancillary tests. CA is widely considered the gold standard of these, as it provides the most reliable assessment of intracranial blood flow. CT angiography (CTA) is a noninvasive and widely available study that is also capable of identifying absent or severely diminished intracranial blood flow, but it is not included among the AAN's accepted ancillary tests because of insufficient evidence demonstrating its reliability...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28296682/causes-and-characteristics-of-death-in-intensive-care-units-a-prospective-multicenter-study
#6
Jean-Christophe Orban, Yannick Walrave, Nicolas Mongardon, Bernard Allaouchiche, Laurent Argaud, Frédéric Aubrun, Geneviève Barjon, Jean-Michel Constantin, Gilles Dhonneur, Jacques Durand-Gasselin, Hervé Dupont, Michèle Genestal, Chloé Goguey, Philippe Goutorbe, Bertrand Guidet, Hervé Hyvernat, Samir Jaber, Jean-Yves Lefrant, Yannick Mallédant, Jerôme Morel, Alexandre Ouattara, Nicolas Pichon, Anne-Marie Guérin Robardey, Michel Sirodot, Alexandre Theissen, Sandrine Wiramus, Laurent Zieleskiewicz, Marc Leone, Carole Ichai
BACKGROUND: Different modes of death are described in selected populations, but few data report the characteristics of death in a general intensive care unit population. This study analyzed the causes and characteristics of death of critically ill patients and compared anticipated death patients to unexpected death counterparts. METHODS: An observational multicenter cohort study was performed in 96 intensive care units. During 1 yr, each intensive care unit was randomized to participate during a 1-month period...
March 15, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28279695/categorization-of-survival-and-death-after-cardiac-arrest
#7
E A Matthews, J Magid-Bernstein, A Presciutti, A Rodriguez, D Roh, S Park, J Claassen, S Agarwal
BACKGROUND: Most cardiac arrest (CA) patients remain comatose post-resuscitation, prompting goals-of-care (GOC) conversations. The impact of these conversations on patient outcomes has not been well described. METHODS: Patients (n=385) treated for CA in Columbia University ICUs between 2008-2015 were retrospectively categorized into various modes of survival and death based on documented GOC discussions. Patients were deemed "medically unstable" if there was evidence of hemodynamic instability at the time of discussion...
March 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28276658/safety-and-outcomes-in-100-consecutive-donation-after-circulatory-death-liver-transplants-using-a-protocol-that-includes-thrombolytic-therapy
#8
H Bohorquez, J B Seal, A J Cohen, A Kressel, E Bugeaud, D S Bruce, I C Carmody, T W Reichman, N Battula, M Alsaggaf, G Therapondos, N Bzowej, G Tyson, S Joshi, R Nicolau-Raducu, N Girgrah, G E Loss
Donation after circulatory death (DCD) liver transplantation (LT) reportedly yields inferior survival and increased complication rates compared with donation after brain death (DBD). We compare 100 consecutive DCD LT using a protocol that includes thrombolytic therapy (late DCD group) to an historical DCD group (early DCD group n=38) and a cohort of DBD LT recipients (DBD group n=435). Late DCD LT recipients had better 1 and 3 year graft survival rates than early DCD LT recipients (92% vs. 76.3%, p=0.03 and 91...
March 9, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28266292/two-and-a-half-hours-of-cardiopulmonary-resuscitation-in-a-deceased-brain-dead-donor-before-liver-transplantation-a-good-idea-to-accept
#9
Dieter P Hoyer, Gernot M Kaiser, Andreas Paul, Nikolaos Machairas, Ernesto P Molmenti, Georgios C Sotiropoulos
The sequelae of cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) in organ donors potentially results in ischemic organ injury and graft dysfunction after transplantation. Thresholds of resuscitation times in brain dead liver donors have not been established so far. We report the case of a brain dead liver donor who experienced 2.5 hours of CPR whose liver was successfully transplanted. A 75-year-old male experienced CA and was treated by CPR with streptokinase application for 2.5 hours until stabilization of cardiac function...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28260450/questionnaire-on-brain-death-and-organ-procurement
#10
Saleh Hammad, Manal Alnammourah, Farah Almahmoud, Mais Fawzi, Abdel-Hadi Breizat
OBJECTIVES: The subject of organs for transplant after brain death raises many concerns, including definition and timing of death, how to permit human organ transplant, and the idea of paying for organs. Many ethical concerns are raised regarding regulations and procedures for organ transplant in developing countries. These include where and how to obtain organs and the concept of justice in organ distribution. MATERIALS AND METHODS: We administered 2682 questionnaires to 628 men and 2054 women over 24 months (range, 18 to 70 years old)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260448/pathology-results-at-autopsy-in-brain-dead-patients-with-brain-tumors
#11
Farahnaz Sadegh Beigee, Shagin Shahryari, Meysam Mojtabaee, Mihan Pourabdollah Toutkaboni
OBJECTIVES: Brain tumors are the most challenging causes of brain deaths due to the lack of pathology results in many cases. It is not uncommon to find a brain tumor in a brain-dead patient with no pathology results or neuroradiology reports available; this would exclude the deceased from organ donation. The mortality that occurs while patients are on transplant wait lists motivated us to find a solution to prevent losing brain-dead patients as potential donors. We present our experiences in autopsy examinations of brain tumors and the results of frozen-section pathology...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260435/role-of-more-active-identification-of-brain-dead-cases-in-increasing-organ-donation
#12
Farahnaz Sadegh Beigee, Mojtaba Mohsenzadeh, Shagin Shahryari, Meysam Mojtabaee
OBJECTIVES: Organ donor shortage is a worldwide problem, resulting in 10% to 30% mortality rates for patients on wait lists for organ transplant. For brain-dead patients in Iran, it is mandatory for intensive care unit patients with Glasgow Coma Scale below 5/15 to be reported to an organ procurement unit. However, this process has not been functioning effectively. Here, we present the effects of changing the strategies on detecting brain-dead cases on the organ donor pool. MATERIALS AND METHODS: From March 2015 to March 2016, we changed our strategy in active detection of brain-dead cases...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28257544/navigating-clinical-ethics-using-real-case-constellations-to-guide-learners-and-teachers-in-medicine
#13
Katherine Wasson, Mark Kuczewski, Michael P McCarthy, Kayhan Parsi, Emily E Anderson, Paul Hutchison
Case-based learning is a staple of clinical ethics education in medicine. The sources for medical educators generally are lengthy case books or single, often rare, case analyses in the literature. Busy clinicians may not have the time or inclination to sift through case books to find suitable teaching material, and the latter present unusual cases that many physicians may never encounter in their own practice. Relatively few articles present multiple cases involving ethical issues that are likely to appear in everyday practice in an accessible format for teaching...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257369/to-see-or-not-to-see-ultrasound-as-an-ancillary-study-to-determine-brain-death
#14
Thomas A Nakagawa, Mudit Mathur
No abstract text is available yet for this article.
March 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28255927/acmt-position-statement-determining-brain-death-in-adults-after-drug-overdose
#15
Mark J Neavyn, Andrew Stolbach, David M Greer, Lewis S Nelson, Silas W Smith, Jeffrey Brent, Laura M Tormoehlen
No abstract text is available yet for this article.
March 2, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28254437/brain-death-after-decompressive-craniectomy-incidence-and-pathophysiological-mechanisms
#16
Farid Salih, Tobias Finger, Peter Vajkoczy, Stefan Wolf
PURPOSE: Patients who received decompressive craniectomy (DC) are usually not regarded to qualify for brain death (BD) as intracranial pressure (ICP) is not assumed to reach levels critical enough to cause cerebral perfusion failure. Here we investigated the incidence of BD after DC and analyzed the pathophysiological mechanisms. MATERIALS AND METHODS: We searched our chart records of patients with DC for individuals who developed BD (2010-2016). We then analyzed the course of ICP and cerebral perfusion pressure (CPP) prior to BD and results from radiological tests that aim at demonstrating loss of cerebral perfusion in BD...
February 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28252534/extracorporeal-membrane-oxygenation-for-adult-community-acquired-pneumonia-outcomes-and-predictors-of-mortality
#17
Kollengode Ramanathan, Chuen Seng Tan, Peter Rycus, Graeme Maclaren
OBJECTIVES: Extracorporeal membrane oxygenation is a rescue therapy used to support severe cardiorespiratory failure. Data on outcomes from severe community-acquired pneumonia in adults receiving rescue extracorporeal membrane oxygenation are mainly confined to single-center experiences or specific pathogens. We examined data from the Extracorporeal Life Support Organisation registry to identify risk factors for poor outcomes in adult patients with community-acquired pneumonia. DESIGN: Retrospective data analysis...
March 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28252345/evidence-of-stress-in-%C3%AE-cells-obtained-with-laser-capture-microdissection-from-pancreases-of-brain-dead-donors
#18
Aref Ebrahimi, Min-Ho Jung, Jonathan M Dreyfuss, Hui Pan, Dennis Sgroi, Susan Bonner-Weir, Gordon C Weir
Isolated islets used for transplantation are known to be stressed, which can result from the circumstances of death, in particular brain death, the preservation of the pancreas with its warm and cold ischemia, from the trauma of the isolation process, and the complex events that occur during tissue culture. The current study focused upon the events that occur before the islet isolation procedure. Pancreases were obtained from brain dead donors (n = 7) with mean age 50 (11) and normal pancreatic tissue obtained at surgery done for pancreatic neoplasms (n = 7), mean age 69 (9)...
March 4, 2017: Islets
https://www.readbyqxmd.com/read/28248802/repeat-head-imaging-in-blunt-pediatric-trauma-patients-is-it-necessary
#19
E Patricia Hill, P J Stiles, Jared Reyes, R Joseph Nold, Stephen D Helmer, James M Haan
BACKGROUND: Children with confirmed brain injury usually undergo follow-up computed tomography scan (CT) of the head within 24 hours of admission. To date, no evidence exists to validate the diagnostic or therapeutic value of these repeat CTs. The purpose of this study was to: (1) evaluate progression of traumatic brain injuries, (2) determine if routine repeat imaging changes management, and (3) compare the efficacy of recognizing worsening hemorrhage with serial neurologic examination versus repeat imaging...
February 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28245959/guidelines-for-use-of-computed-tomography-angiogram-as-an-ancillary-test-for-diagnosis-of-suspected-brain-death
#20
REVIEW
Santanu Chakraborty, Sonny Dhanani
No abstract text is available yet for this article.
February 25, 2017: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
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