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https://www.readbyqxmd.com/read/29162023/pentobarbital-removal-during-continuous-venovenous-hemofiltration-case-report-and-review-of-the-literature
#1
David M Hensler, Deepika P McConnell, Kimberly E Levasseur-Franklin, Kasey M Greathouse
BACKGROUND: Renal replacement therapy may enhance the elimination of barbiturates. Pentobarbital clearance during continuous venovenous hemofiltration (CVVH) has not been described previously. We report a patient case involving the measurement of serial pentobarbital levels during CVVH and review relevant literature characterizing extracorporeal pentobarbital elimination. METHODS: The following is a retrospective report of a previously healthy 26-year-old woman who sustained a severe traumatic brain injury (TBI) and required administration of pentobarbital on hospital day 0 for intracranial pressure (ICP) control...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29150710/computed-tomography-perfusion-is-a%C3%A2-useful-adjunct-to-computed-tomography-angiography-in-the-diagnosis-of-brain-death
#2
M Sawicki, J Sołek-Pastuszka, K Chamier-Ciemińska, A Walecka, J Walecki, R Bohatyrewicz
BACKGROUND: In the diagnosis of brain death (BD), computed tomography angiography (CTA) results in some cases show intracranial filling, leading to diagnostic confusion. Because cerebral circulatory arrest commences at the capillary level, we hypothesized that computed tomography perfusion (CTP) would be a more sensitive approach than CTA; therefore, the aim of the study was to compare the sensitivities of CTP and CTA in the diagnosis of BD. MATERIAL AND METHODS: Whole brain CTP was performed in patients in the intensive care unit diagnosed with BD and CTA was derived from CTP datasets...
November 17, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29149948/knowledge-and-attitudes-toward-organ-donation-in-health-care-undergraduate-students-in-italy
#3
F Fontana, M Massari, L Giovannini, G Alfano, G Cappelli
INTRODUCTION: The number of organ donors in Italy is increasing, but with still disappointing living donation activity and relatively frequent objection by potential deceased donors' relatives to organ recovery. Few studies have assessed health care students' knowledge and attitude on donation. METHODS: We administered a questionnaire to medical (MS) and nursing students (NS) at University of Modena and Reggio Emilia, Italy, and 749 students (406 MS and 343 NS) completed the questionnaire...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149946/organ-donation-a-comparison-of-donating-and-nondonating-families-in-turkey
#4
F Can, S Hovardaoglu
Based on public opinion surveys, although 75% of people state that they would donate the organs of one of their relatives, in reality, the rate of the people who donate the organs of their relatives is 24%. To decrease the organ shortage, the key point is to understand the difference between intention and real behavior. For this reason, in this study, analyses of variables related to the potential organ donor families' decisions of approval or refusal for organ harvesting were analyzed. The interviews were conducted with 101 families who made a decision about organ donation between 2010 and 2014...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149396/a-survey-on-pediatric-brain-death-and-on-organ-transplantation-how-did-the-law-amendment-change-the-awareness-of-pediatric-healthcare-providers
#5
Takashi Araki, Hiroyuki Yokota, Koutaro Ichikawa
OBJECTIVES: In Japanese society taking a cautious attitude towards organ transplantation, we investigate how amendment of the Organ Transplant Law which legalized brain death (BD) determination criteria changed the awareness concerning BD and organ transplantation of pediatric healthcare providers. METHODS: The questionnaire survey adopted the bearer method and was sent to members of the Japanese Society of Emergency Pediatrics (JSEP). In both the surveys of 2008 and 2016, the same item "Questionnaire survey on BD and organ transplant" was disseminated...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29135481/role-and-limitations-of-transcranial-doppler-and-brain-death-of-patients-on-veno-arterial-extracorporeal-membrane-oxygenation
#6
Mino Cestari, André L N Gobatto, Mauricio Hoshino
No abstract text is available yet for this article.
November 8, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29132508/brain-death
#7
REVIEW
Mack Drake, Andrew Bernard, Eugene Hessel
Death determined by neurologic criteria, commonly referred to as "brain death," occurs when function of the entire brain ceases, including the brain stem. Diagnostic criteria for brain death are explicit but controversy exists regarding nuances of the evaluation and potential confounders of the examination. Hospitals and ICU teams should carefully consider which clinicians will perform brain death testing and should use standard processes, including checklists to prevent diagnostic errors. Proper diagnosis is essential because misdiagnosis can be catastrophic...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29129151/false-positive-diagnosis-of-brain-death-following-the-pediatric-guidelines-case-report-and-discussion
#8
D Alan Shewmon
A 2-year-old boy with severe head trauma was diagnosed brain dead according to the 2011 Pediatric Guidelines. Computed tomographic (CT) scan showed massive cerebral edema with herniation. Intracranial pressures were extremely high, with cerebral perfusion pressures around 0 for several hours. An apnea test was initially contraindicated; later, one had to be terminated due to oxygen desaturation when the Pco2 had risen to 57.9 mm Hg. An electroencephalogram (EEG) was probably isoelectric but formally interpreted as equivocal...
December 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/29128780/apnea-testing-using-the-oxygen-insufflation-method-for-diagnosis-of-brain-death-may-compromise-pulmonary-function
#9
Joanna Sołek-Pastuszka, Marcin Sawicki, Waldemar Iwańczuk, Klaudyna Kojder, Wojciech Saucha, Zenon Czajkowski, Kornel Chełstowski, Romuald Bohatyrewicz
INTRODUCTION: The aim of our study was to compare the reliability and safety of the classical I-AT with the continuous positive airway pressure apnea test (CPAP-AT). MATERIAL AND METHODS: In the group of 48 patients (group O), an I-AT was performed at the end of BD diagnostic procedures, and approximately 1-1.5h later CPAP-AT with 100% FiO2 and CPAP of 10cm H2O, provided by ventilator in CPAP mode. After pre‑oxygenation with 100% FiO2 for 10min, the PaO2/FiO2 ratio was recorded prior to I-AT at time-point one (T1) and prior to CPAP-AT at time-point two (T2)...
October 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29125053/twenty-minutes-of-normothermic-cardiac-arrest-in-a-pig-model-the-role-of-short-term-hypothermia-for-neurological-outcome
#10
Katharina Foerster, Christoph Benk, Friedhelm Beyersdorf, Heidi Cristina Schmitz, Karin Wittmann, Itumeleng Taunyane, Claudia Heilmann, Georg Trummer
INTRODUCTION: Cardiopulmonary resuscitation restores circulation, but with inconsistent blood-flow and pressures. Our recent approach using an extracorporeal life support system, named "controlled integrated resuscitation device" (CIRD), may lead to improved survival and neurological recovery after cardiac arrest (CA). The basic idea is to provide a reperfusion tailored to the individual patient by control of the conditions of reperfusion and the composition of the reperfusate. Hypothermia is one aspect of this concept...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29123832/pupil-diameter-for-confirmation-of-brain-death-in-adult-organ-donors-in-japan
#11
Katsuyuki Sagishima, Yoshihiro Kinoshita
Aim: The criteria for brain death in Japan include a bilateral pupil diameter of ≥4 mm. We evaluated the appropriateness of a 4-mm pupil diameter in adult brain-dead donors in Japan. Methods: We retrospectively reviewed the records of 148 consecutive adult brain-dead donors with an average age of 46 years. All records were anonymously registered to the Japanese Ministry of Health, Labour and Welfare (the Japanese Ministry of Health and Welfare before 2001) from the various designated emergency institutes that performed organ donation under brain death from 1999 to 2012 in Japan...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29110788/worldwide-trends-in-heart-and-lung-transplantation-guarding-the-most-precious-gift-ever
#12
REVIEW
Vera von Dossow, Joseph Costa, Frank D'Ovidio, Nandor Marczin
Transplantation is sadly a therapy to die for. The survival of a recipient with end-stage heart or lung disease requires the demise of a human being through brain death or cessation of circulation, with the noblest final act of offering one's organs to another. However, transplantation is constrained by severe hemodynamic, regulatory, inflammatory, and metabolic stresses in the donor, rendering the majority of offered organs unsuitable for transplantation. Coupled with our inability to acquire exact molecular and cellular information and missed opportunities for effectively modulating deteriorations of donors and allografts, anesthesia and critical care contributes to ongoing organ shortages...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29109872/severe-decompression-illness-case-report-prehospital-recognition-and-regional-transport-considerations
#13
Julie Estrada, David Meurer, Kevin De Boer, Karl Huesgen
A 46-year-old male presented to our tertiary care emergency department (ED) with shortness of breath and chest pain following an uneventful four-hour SCUBA dive at 100 feet. His prehospital emergency medical services (EMS) assessment revealed transient hypotension and hypoxia. He later developed progressive skin mottling. Serology was significant for acute kidney injury, transaminitis, hemoconcentration, and hypoxia on an arterial blood gas. Computed tomography (CT) angiography demonstrated intravascular gas throughout the mesenteric and pulmonary arteries as well as the portal venous system...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29108406/intracerebral-hemorrhage-in-intensive-care-unit-early-prognostication-fallacies-a-single-center-retrospective-study
#14
Stefano Spina, Chiara Marzorati, Alessia Vargiolu, Federico Magni, Matteo Riva, Matteo Rota, Carlo Giussani, Erik P Sganzerla, Giuseppe Citerio
BACKGROUND: Intracerebral hemorrhage (ICH) admitted to intensive care is deem of poor prognosis. To compare observed and predicted 30-days mortality and to evaluate long term functional outcome in a consecutive ICH cohort. METHODS: Retrospective analysis of prospectively collected data of ICH patients managed in a Neuro-ICU from 2012 to 2015. RESULTS: 136 consecutive patients; 34 (25%) had "withholding of life-sustaining treatment" (WLST) order and 102 (75%) received a "full treatment" (FT)...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29092874/determining-brain-death-basic-approach-and-controversial-issues
#15
Angela Nelson, Ariane Lewis
No abstract text is available yet for this article.
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29076900/absent-cerebellar-circulation-with-intact-cerebral-blood-flow-on-a-99mtc-bicisate-brain-death-study
#16
Matthew Q Schmidt, Frank V Schraml
A 55-year old woman presented in an obtunded state and was found to have a subarachnoid hemorrhage. After endovascular repair, her condition deteriorated, and brain death was suspected. A Tc bicisate brain blood flow study was performed, which showed a complete absence of blood flow to the cerebellum despite intact circulation to the cerebral hemispheres. These atypical findings are likely a result of a transient intracranial pressure differential and the timing of the study. A timely and accurate declaration of brain death has important psychosocial and ethical implications, particularly when organ donation is being considered...
October 26, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29074840/survey-regarding-attitude-of-family-about-organ-donation-after-brain-death-in-korea
#17
Hyun Ji Lee, Myung Jae Jin, Sang Youb Han, Kum Hyun Han, Se Won Oh, Hye-Yeon Jang, Ui Jun Park, Hyoung Tae Kim, Young-Nam Roh
BACKGROUND This study examined the attitude of patients' relatives in South Korea toward organ donation after brain death. MATERIAL AND METHODS A structured questionnaire was used to obtain the information on the attitude toward organ donation for relatives of patients who were admitted to the surgical intensive care unit (SICU) between March 1, 2014 and September 30, 2016. In total, 92 persons participated voluntarily. The investigation included general opinion about organ donation; and additional categorical analysis was performed...
October 27, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29067599/legislative-enforcement-of-nonconsensual-determination-of-neurological-brain-death-in-muslim-patients-a-violation-of-religious-rights
#18
Mohamed Y Rady, Joseph L Verheijde
Death is defined in the Quran with a single criterion of irreversible separation of the ruh (soul) from the body. The Quran is a revelation from God to man, and the primary source of Islamic knowledge. The secular concept of death by neurological criteria, or brain death, is at odds with the Quranic definition of death. The validity of this secular concept has been contested scientifically and philosophically. To legitimize brain death for the purpose of organ donation and transplantation in Muslim communities, Chamsi-Pasha and Albar (concurring with the US President's Council on Bioethics) have argued that irreversible loss of capacity for consciousness and breathing (apneic coma) in brain death defines true death in accordance with Islamic sources...
October 24, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/29027352/impact-of-spontaneous-donor-hypothermia-on-graft-outcomes-after-kidney-transplantation
#19
P Schnuelle, H M Mundt, F Drüschler, W H Schmitt, B A Yard, B K Krämer, U Benck
A previous donor intervention trial found that therapeutic hypothermia reduced delayed graft function (DGF) after kidney transplantation. This retrospective cohort study nested in the randomized dopamine trial (ClinicalTrials. gov identifier: NCT000115115) investigates the effects of spontaneous donor hypothermia (core body temperature <36°C) on initial kidney graft function, and evaluates five-year graft survival. Hypothermia assessed by a singular measurement in the ICU 4-20 hours before procurement was associated with less DGF after kidney transplantation (OR 0...
October 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29026570/calypso-s-spell-accidental-near-fatal-thiacloprid-intoxication
#20
Patrick Zuercher, Daniel Gerber, Nadia Schai, Matthias Nebiker, Stefan König, Joerg C Schefold
Acute life-threatening intoxications with insecticides are rare. We report a case of accidental near-fatal thiacloprid intoxication with mass spectrometry-based analytical confirmation. The initial clinical presentation resembled imminent brain death and/or severe postanoxic encephalopathy. Prolonged supportive treatment resulted in full recovery underlining intoxication as an important differential diagnosis in unclear coma.
October 2017: Clinical Case Reports
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