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Med Intensiva ; 41(9): 559-568, 2017 Dec.
Article in English, Spanish | MEDLINE | ID: mdl-28318674

ABSTRACT

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. Aspects such as catecholamine storm management, use of vasoactive drugs, hemodynamic objectives and monitoring, assessment of the heart for donation, and general care of the donor in BD are reviewed.


Subject(s)
Brain Death , Practice Guidelines as Topic , Tissue Donors , Tissue and Organ Procurement/methods , Brain Death/diagnosis , Catecholamines/metabolism , Critical Care/standards , Enteral Nutrition , Hemodynamics , Humans , Terminal Care/standards , Thyroid Hormones/therapeutic use , Tissue and Organ Harvesting , Tissue and Organ Procurement/standards , Vasoconstrictor Agents/therapeutic use
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