Imminent Brain Death and the DCD-N ScoreUsing the DCD-N score will predict death within 60 minutes...

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Department of Intensive Care Erasmus MC University Medical Center Rotterdam Imminent Brain Death and the DCD-N Score Tools for potential organ donor recognition dr Erwin J.O. Kompanje

Transcript of Imminent Brain Death and the DCD-N ScoreUsing the DCD-N score will predict death within 60 minutes...

  • Department of Intensive Care

    Erasmus MC University Medical Center Rotterdam

    Imminent Brain Deathand

    the DCD-N Score

    Tools for potential organ donor recognition

    dr Erwin J.O. Kompanje

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    Organ transplantation

    Problems in 1950-1970

    1.Warm ischemia of the dead donor2. Rejection of the transplanted organ

    Problems nowadays

    1. Low availability of donor organs (more patients on the waiting lists than donor-

    organs available)2. Long term co-morbidity (malignancies)

    after transplantation

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    Waiting list and supply of kidneys

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    University Medical

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    Waiting list and supply of hearts

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    Donation rates (per million/population) in the European Union (2007)

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    Most important reasons for low number of donor organs

    1. Progress in effective prevention and effective treatment of acute neurological conditions

    2. Refusal to donate organs of a deceased relative

    3. Non-recognition of a potential organ donor by professionals

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    University Medical

    Center Rotterdam Brain death is, and has always been, a rare

    outcome of neuro-critical care in a selected cohort of patients

    c. 3% of all patients who die on a neurocritical care unit die from brain death. Less than 1%

    on general ICUs.

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    Brain death, underlying conditions

    Analysis of 71 series (1968-2008)N= 6317 [83% SAH, TBI, ICH]

    60% SAH, 8% ICH 15% TBI

    Kompanje, 2009

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  • Afdeling

    Intensive

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    Erasmus

    MC Universitair Medisch

    Centrum

    Rotterdam

    ‘Between 1970 and 1999, total traffic fatalities declined, on average by 35% in 32 European

    countries and USA, while total vehicle kilometres driven increased by over 250%’

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    How to increase the number of donor organs?

    1. Increase living organ donation2. Lowering family refusal3. Better potential organ donor recognition leading to a better Donor Conversion Rate

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    Organ donor recognition

    1. Recognition of the potential brain-dead organ donor2. Recognition of the potential circulatory death donor

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    Imminent brain death

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    Imminent brain death

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    Center Rotterdam

    Organ donor recognition

    1. Recognition of the potential brain-dead organ donor2. Recognition of the potential circulatory death donor

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    Conclusions

    1. Uniform definition of a potential brain dead organ donor (imminent brain death) will lead to higher donor conversion rate and allows better comparison between countries and hospitals

    2. Using the DCD-N score will predict death within 60 minutes after withdrawal of life support which will lead to a higher donor conversion rate, less burden for relatives and better use of resources

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Controlled DCD - clodlog.com pathway.pdf · Controlled DCD The clinical pathway! Dr Paul Murphy ... DBD donors DCD donors. Controlled DCD – key elements of the pathway The Maastricht

Controlled DCD - clodlog.com pathway.pdf · Controlled DCD The clinical pathway! Dr Paul Murphy ... DBD donors DCD donors. Controlled DCD – key elements of the pathway The Maastricht

Caring for Client When Death is Imminent

Caring for Client When Death is Imminent

Performance Report 2011 - donatelife.gov.au · from the Donation after Brain Death (DBD)* pathway, with the remaining 25% (85) from the Donation after Cardiac Death (DCD)** pathway.

Performance Report 2011 - donatelife.gov.au · from the Donation after Brain Death (DBD)* pathway, with the remaining 25% (85) from the Donation after Cardiac Death (DCD)** pathway.

Labor Day Grace. Death is imminent One last email Or letter.

Labor Day Grace. Death is imminent One last email Or letter.

FINAL REPORT - Ministero Salute · 2018-12-05 · of such variations on the potential for donation after brain death (DBD) and that of donation after circulatory death (DCD), and

FINAL REPORT - Ministero Salute · 2018-12-05 · of such variations on the potential for donation after brain death (DBD) and that of donation after circulatory death (DCD), and

A statement by a person who is conscious and knows that death is imminent concerning what he or she believes to be the cause or circumstances of death.

A statement by a person who is conscious and knows that death is imminent concerning what he or she believes to be the cause or circumstances of death.

Recognizing Imminent Death

Recognizing Imminent Death

DFS Approved Curriculum-Unit 121 Unit 12 Caring For Resident When Death Is Imminent and Following Death Nurse Aide I Course.

DFS Approved Curriculum-Unit 121 Unit 12 Caring For Resident When Death Is Imminent and Following Death Nurse Aide I Course.

Death at 50 Organ Donation - ucdenver.edu · Donation after Brain Death (DBD) Pathway Donation after circulatory death (DCD) Pathway Irreversible loss of all brain function Irreversible

Death at 50 Organ Donation - ucdenver.edu · Donation after Brain Death (DBD) Pathway Donation after circulatory death (DCD) Pathway Irreversible loss of all brain function Irreversible

Why we need DCD - Lifesharing · Why we need DCD Randolph Schaffer ... • History of DCD • Early hopes • Clinical outcomes ... compared to organs from DBD • DCD should be an

Why we need DCD - Lifesharing · Why we need DCD Randolph Schaffer ... • History of DCD • Early hopes • Clinical outcomes ... compared to organs from DBD • DCD should be an

coordinated by ONT, Spainelundidoonorlus.ee/failid/File/ACCORD_eng/ACCORD_Layman...brain death (DBD) and that of donation after circulato-ry death (DCD) in Europe, with evident opportunities

coordinated by ONT, Spainelundidoonorlus.ee/failid/File/ACCORD_eng/ACCORD_Layman...brain death (DBD) and that of donation after circulato-ry death (DCD) in Europe, with evident opportunities

Modbus Dcd

Modbus Dcd

DCD MEDIA PLC€¦ · DCD Media Plc 1 Financial statements for the year ended 31 December 2018 DCD Media Plc (“DCD Media” or the “Company”) Audited results for the year ended

DCD MEDIA PLC€¦ · DCD Media Plc 1 Financial statements for the year ended 31 December 2018 DCD Media Plc (“DCD Media” or the “Company”) Audited results for the year ended

coordinated by ONT, Spain · brain death (DBD) and that of donation after circulato-ry death (DCD) in Europe, with evident opportunities for improvement. wp 5 Promoting the cooperation

coordinated by ONT, Spain · brain death (DBD) and that of donation after circulato-ry death (DCD) in Europe, with evident opportunities for improvement. wp 5 Promoting the cooperation

Unit 12 Caring For Resident When Death Is Imminent and Following Death

Unit 12 Caring For Resident When Death Is Imminent and Following Death

When death is imminent

When death is imminent

DEPPART: predikce úmrtí a fyziologie umírání...Petr Waldauf KAR FNKV • DBD = Donation after Brain Death • DCD = Donation after Circulatory Death • WLST = Withdrawal of Life-Sustaining

DEPPART: predikce úmrtí a fyziologie umírání...Petr Waldauf KAR FNKV • DBD = Donation after Brain Death • DCD = Donation after Circulatory Death • WLST = Withdrawal of Life-Sustaining

Imminent Grey

Imminent Grey

DCD MP 2011

DCD MP 2011

Imminent Dusk

Imminent Dusk