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https://www.readbyqxmd.com/read/28444410/-apnea-test-for-assessment-of-brain-death-under-extracorporeal-life-support
#1
REVIEW
S Winter, H V Groesdonk, M Beiderlinden
BACKGROUND: The fourth edition of the German guideline for the assessment of brain death, published in 2015 by the German Medical Council (Bundesärztekammer), emphasizes the importance of an apnea test. It is also now required under all circumstances of extracorporeal life support. OBJECTIVES: This article is an instruction for the guideline-conforming performance of an apnea test in general and also in cases of extracorporeal life support in different configurations...
April 25, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28429866/successful-multiple-organ-donation-after-donor-brain-death-due-to-actinomyces-israelii-meningitis
#2
Leonel Lagunes, Oscar Len, Alberto Sandiumenge, Elena Martínez-Saez, Tomás Pumarola, Marta Bodro, Antonio Macías, Jose T Silva, F Xavier Nuvials, Ramon Charco, Francesc Moreso, Teresa Pont
The increasing gap between availability of solid organs for transplantation and the demand has led to the inclusion of donors which according to current guidelines may be discarded, some of them because of the possibility for transmission of infection to their recipients. We present the first report, to the best of our knowledge, of a case of a brain-dead donor with a localized and treated Actinomyces israelii central nervous system infection who, after a thorough evaluation, led to successful transplant procedures in four recipients...
April 21, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28426684/long-term-results-after-transplantation-of-pediatric-liver-grafts-from-donation-after-circulatory-death-donors
#3
Rianne van Rijn, Pieter E R Hoogland, Frank Lehner, Ernest L W van Heurn, Robert J Porte
BACKGROUND: Liver grafts from donation after circulatory death (DCD) donors are increasingly accepted as an extension of the organ pool for transplantation. There is little data on the outcome of liver transplantation with DCD grafts from a pediatric donor. The objective of this study was to assess the outcome of liver transplantation with pediatric DCD grafts and to compare this with the outcome after transplantation of livers from pediatric donation after brain death (DBD) donors. METHOD: All transplantations performed with a liver from a pediatric donor (≤16 years) in the Netherlands between 2002 and 2015 were included...
2017: PloS One
https://www.readbyqxmd.com/read/28421189/optic-nerve-sheath-diameter-ultrasound-evaluation-in-intensive-care-unit-possible-role-and-clinical-aspects-in-neurological-critical-patients-daily-monitoring
#4
M Toscano, G Spadetta, P Pulitano, M Rocco, V Di Piero, O Mecarelli, E Vicenzini
Background. The increase of the optic nerve sheath diameter (ONSD) is a reliable, noninvasive sonographic marker of intracranial hypertension. Aim of the study was to demonstrate the efficacy of ONSD evaluation, when monitoring neurocritical patients, to early identify malignant intracranial hypertension in patients with brain death (BD). Methods. Data from ultrasound ONSD evaluation have been retrospectively analyzed in 21 sedated critical patients with neurological diseases who, during their clinical course, developed BD...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28397363/improved-time-to-notification-of-impending-brain-death-and-increased-organ-donation-using-an-electronic-clinical-decision-support-system
#5
J L Zier, A B Spaulding, M Finch, T Verschaetse, R Tarrago
Early referral of patients to an organ procurement organization (OPO) may positively impact donation outcomes. We implemented an electronic clinic decision support (CDS) system to automatically notify our OPO of children meeting clinical triggers indicating impending brain death. Medical records of all patients who died in a pediatric critical care unit or were referred for imminent death for three years prior to installation of the initial CDS (pre-CDS) and for one year after implementation of the final CDS (post-CDS) were reviewed...
April 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28393670/confounding-brain-stem-function-during-pediatric-brain-death-determination-two-case-reports
#6
Gregory Hansen, Ari R Joffe
A patient who has been declared brain dead is considered to be both legally and clinically dead. However, we report 2 pediatric cases in which the patients demonstrated clinical signs of brain stem function that are not recognized or tested in current Canadian or US guidelines.
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28390648/hospital-characteristics-associated-with-increased-conversion-rates-among-organ-donors-in-new-england
#7
Arturo J Rios-Diaz, Olubode A Olufajo, Jill Stinebring, Samantha Endicott, Brandon T McKown, David Metcalfe, Cheryl K Zogg, Ali Salim
BACKGROUND: It is unknown whether hospital characteristics affect institutional performance with regard to organ donation. We sought to determine which hospital- and patient-level characteristics are associated with high organ donor conversion rates after brain death (DBD). METHODS: Data were extracted from the regional Organ Procurement Organization (2011-2014) and other sources. Hospitals were stratified into high-conversion hospitals (HCH; upper-tertile) and low-conversion hospitals (LCH; lower-tertile) according to conversion rates...
March 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28387940/the-bial-10-2474-phase-1-study-a-drug-development-perspective-and-recommendations-for-future-first-in-human-trials
#8
REVIEW
Philip Chaikin
BIA 10-2474 (a fatty acid amide hydrolase inhibitor) was evaluated in a first-in-human phase 1 study in normal volunteers to assess safety/tolerability, pharmacokinetics, pharmacodynamics, and food effect. The dose-escalation process consisted of a single-ascending-dose phase (SAD) and multiple-ascending-dose phase (MAD). Prospective determination of the starting dose and maximal escalated dose was consistent with the usual clinical pharmacology principles for extrapolation of preclinical toxicology data to human equivalent doses...
April 7, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28379853/donation-after-circulatory-death-heart-transplantation
#9
Kumud K Dhital, Hong C Chew, Peter S Macdonald
PURPOSE OF REVIEW: Despite continued expansion in the use of extended-criteria donor hearts following donation after brain death, there remains an unacceptable discrepancy between the supply of suitable donor hearts and the demand from increasing recipient numbers on transplant wait lists. Until recently, the additional approach of utilizing organs following donation after circulatory death (DCD) had not been possible for clinical heart transplantation in the modern era. This review describes relevant advances in translational research and provides an update on the favourable adoption of this donation pathway for clinical heart transplantation...
April 4, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28376778/outcomes-for-primary-kidney-transplantation-from-donation-after-citizens-death-in-china-a-single-center-experience-of-367-cases
#10
Wujun Xue, Puxun Tian, Heli Xiang, Xiaoming Ding, Xiaoming Pan, Hang Yan, Jun Hou, Xinshun Feng, Linjuan Liu, Chenguang Ding, Xiaohui Tian, Yang Li, Jin Zheng
BACKGROUND: The cases of donation after brain death followed by circulatory death (DBCD) and donation after cardiac death (DCD) have been increased year by year in China. Further research is needed to understand in the outcomes and risk factors of delayed graft function (DGF) in order to minimize the risk of DGF and ameliorate its potential impact on long-term outcomes. This study was to explore the differences in outcomes between DBCD and DCD transplant and the main risk factors for DGF in DBCD...
April 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28376670/in-re-guardianship-of-hailu-the-nevada-supreme-court-casts-doubt-on-the-standard-for-brain-death-diagnosis
#11
Greg Yanke, Mohamed Y Rady, Joseph L Verheijde
In the recent court case of In Re Guardianship of Hailu, the Nevada Supreme Court cast doubt on the acceptability of the American Academy of Neurology's guidelines as a medical standard for determining brain death. The Uniform Determination of Death Act, which has been adopted in every state, requires that brain death diagnoses be made in accordance with accepted medical standards. The Court expressed concern that the guidelines fail to ensure that there is an irreversible cessation of all functions of a person's entire brain, which is a component of the Act's definition of death...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/28352638/variability-in-diagnosing-brain-death-at-an-academic-medical-center
#12
Ashutosh Pandey, Pradeep Sahota, Premkumar Nattanmai, Christopher R Newey
Objective. Research continues to highlight variability in hospital policy and documentation of brain death. The aim of our study was to characterize how strictly new guidelines of American Academy of Neurology (AAN) for death by neurological criteria were practiced in our hospital prior to appointment of neurointensivists. Method. This is a retrospective study of adults diagnosed as brain dead from 2011 to 2015. Descriptive statistics compared five categories: preclinical testing, neurological examination, apnea tests, ancillary test, and documentation of time of death...
2017: Neuroscience Journal
https://www.readbyqxmd.com/read/28352007/dynamic-renal-scintigraphic-estimation-of-deceased-donor-kidneys-in-a-rat-model
#13
Huseyin Aydin Mitil, Zehra Pınar Koç, Yunus Guzel, Mustafa Kom, A Belin Ozer, I Hanefi Ozercan, Tansel Ansal Balcı
At present a large number of the renal transplantations are being performed from the deceased donors. The success of these transplantations depends on the viability of the deceased donor kidneys. The aim of this study was to investigate the reliability of scintigraphic estimation of function of deceased donor kidneys by comparing the histopathologic and scintigraphic findings. Ten rats were included in the study (2-3 months old, 250-300 g, all male). Control scintigraphy was performed to all the rats by injection of 37 MBq Tc-99m DTPA from the tail vein in a dynamic manner...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28345064/pneumocephalus-in-a-patient-with-multiple-stab-wounds
#14
Yusuf Savran, Volkan Karacam, Basak Bayram, Erdem Yaka, Nuri Karabay
Pneumocephalus is a complication of trauma to the chest and many iatrogenic interventions. It may arise due to systemic air embolism or retrograde cerebral venous air embolism which is an extremely rare complication. We report a 26-years-old female patient who presented to the Emergency Department suffering of multiple stab wounds. She was in a state of shock and after first aid and evaluation she was operated successfully. In the early postoperative period generalized tonic clonic convulsions were observed following cardiopulmonary resuscitation due to sudden cardiovascular collapse...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28340798/effect-of-interviews-done-by-intensive-care-physicians-on-organ-donation
#15
D Birtan, M K Arslantas, P C Dincer, G T Altun, B Bilgili, F B Ucar, C A Bozoklar, H O Ayanoglu
In this study, we examined the correspondence between intensive care unit physicians and the relatives of potential brain-dead donors regarding the decision to donate or the reasons for refusing organ donation. A total of 12 consecutive cases of potential brain-dead patients treated in intensive care units of Marmara University Pendik Education and Research Hospital in 2013 were evaluated. For each of the cases, the Potential Donor Questionnaire, and Family Notification, Brain Death Criteria Fulfilment and Organ Donation Conversation Questionnaires were used to collect the required data...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340797/numbers-of-brain-deaths-and-deceased-donors-in-hospitals-in-istanbul-region-that-have-transplantation-units-a-retrospective-analysis-between-the-years-2005-and-2015
#16
A K Harmanci Seren, H Yavuz
BACKGROUND: Turkey is one of the countries facing a serious organ shortage problem, with thousands of patients with end-stage organ failure. The Social Security Institution started to increase the reimbursement for transplantation operations in 2007 to solve this problem, and this policy has continued since then. Although the number of transplantation centers and operations in Turkey increased in this term, according to organ donation and transplantation statistics from the Ministry of Health, the rate of organ retrieval from deceased organ donors has decreased...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28332628/ginkgo-biloba-extract-egb761-attenuates-brain-death-induced-renal-injury-by-inhibiting-pro-inflammatory-cytokines-and-the-sapk-and-jak-stat-signalings
#17
Yifu Li, Yunyi Xiong, Huanxi Zhang, Jun Li, Dong Wang, Wenfang Chen, Xiaopeng Yuan, Qiao Su, Wenwen Li, Huiting Huang, Zirong Bi, Longshan Liu, Changxi Wang
This study aimed to investigate the protective effects of EGb761, a Ginkgo Biloba extract, against brain death-induced kidney injury. Sixty male Sprague Dawley rats were randomly divided into six groups: sham, brain-death (BD), BD + EGb b48h (48 hours before BD), BD + EGb 2 h (2 hours after BD), BD + EGb 1 h, and BD + EGb 0.5 h. Six hours after BD, serum sample and kidney tissues were collected for analyses. The levels of blood urea nitrogen (BUN) and serum creatinine significantly elevated in the BD group than in sham group...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28323775/inadequate-antioxidative-responses-in-kidneys-of-brain-dead-rats
#18
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
#19
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
#20
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
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