Anesthesia For Organ Donation
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Anesthesia for organ donation: COMMON PHYSIOLOGIC DERANGEMENTS AFTER BRAIN DEATH Condition Cause Hypotension Hypovolemia (DI; hemorrhage) Neurogenic shock Hypoxemia
Neurogenic pul edema, Pul contusion, Pneumonia Gastric aspiration, Fluid overload
Hypothermia
Hypothalamic infarction, Exposure
Dysrhythmia (especially bradycardia) • • • • •
Intracranial injury or herniation, Hypothermia Hypoxia, Electrolyte abnormality Myocardial contusion, ischemia Avoid vasopressors → may cause visceral ischemia Consider using low dose Dopamine if needed They are atropine resistance Consider use NDMR due to somatic spinal reflex No need for GA, for ↑ BP consider use vasodilators
Neurogenic pul edema, Pul contusion, Pneumonia Gastric aspiration, Fluid overload
Hypothermia
Hypothalamic infarction, Exposure
Dysrhythmia (especially bradycardia) • • • • •
Intracranial injury or herniation, Hypothermia Hypoxia, Electrolyte abnormality Myocardial contusion, ischemia Avoid vasopressors → may cause visceral ischemia Consider using low dose Dopamine if needed They are atropine resistance Consider use NDMR due to somatic spinal reflex No need for GA, for ↑ BP consider use vasodilators
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