The End-of-Life Care Family Meeting is a core component of ICU care; Evidence suggests that communication with families is often inadequate; The principles apply to end-of-life discussions in other settings (e.g. ED) as well
Donation after Circulatory Death (DCD) refers to organ donation taking place once circulatory arrest has occurred following treatment withdrawal
DBD = donation after brain death; DCD = donation after cardiac death; WIT = time from treatment withdrawal until cold perfusion (most important phase = when SBP < 60mmHg)
Coma-like Syndromes
Changes in Brain Death Consensus Statement (V3.2 2013)
Brain death is the irreversible loss of all functions of the brain, including the brainstem. The three essential findings in brain death are coma (unresponsiveness), absence of brainstem reflexes, and apnoea
To make the diagnosis of brain death the examiner must be able recognise responses that do not require brain function; stimulus-provoked movements should be termed reflexes and spontaneous movements termed automatisms; brain death-associated automatisms may be present in up to 50% of brain death cases
Acute Aortic Dissection: the most common catastrophe of the aorta (3:100,000); 3 times more common than abdominal aortic aneurysm (AAA) rupture
OVERVIEW Involves these steps: Early identification Establish rapport with family early Non-coercive discussion with family regarding opportunity to donate Initiate tissue typing, organ function testing and viral screening Maintain extra-cerebral physiological stability Facilitate family time at the bedside Ensure aftercare…
This page is under construction OVERVIEW “Obviously, except under momentary conditions the venous return and the cardiac output must be equal.” — Arthur Guyton STARLING’S LAW By raising or lowering an artificial venous reservoir, Starling showed that increased right atrial…
This page is under construction OVERVIEW Cardiorenal syndromes (CRS) are disorders of the heart and kidneys whereby acute or long-term dysfunction in one organ may induce acute or long-term dysfunction of the other CRS is characterised by the triad of…
Brain death is the irreversible loss of all functions of the brain, including the brainstem. The three essential findings in brain death are coma (unresponsiveness), absence of brainstem reflexes, and apnoea