Death and organ donation

Question 1

What does DCD refer to?

Answer 1

-Donation after circulatory death
-Retrieval of organs from patients whose death is confirmed using cardio-respiratory criteria

Question 2

What is the difference between controlled and uncontrolled DCD?

Answer 2

-Uncontrolled = after cardiac arrest from which patient cannot / should not be resuscitated
-Controlled = after planned withdrawal of life-sustaining treatments

Question 3

What does DBD refer to?

Answer 3

-Donation after brainstem death
-Death has been confirmed using neurological criteria
-Only possible for patients on mechanical ventilation, as they will have lost the capacity for consciousness and respiration

Question 4

What are the 6 signs of brainstem death?

Answer 4

-Fixed pupils
-No corneal reflex
-No response to supraorbital pressure
-No cough / gag reflex
-No respiratory effort after ventilator disconnection
-No oculovestibular reflexes

Question 5

What common problems are encountered on discharge from ICU?

Answer 5

-COGNITION - memory, problem-solving, can be temporary or permanent
-WEAKNESS - muscle wasting, may take >1 year to fully recover
-MENTAL HEALTH - insomnia, nightmares, depression, anxiety, PTSD