Anaesthetic management of the brain dead for organ donation

Abstract

An increasing number of anaesthetists is being called upon to manage organ donors during organ retrieval procedures. We briefly describe the technical aspects of the surgical procedure together with a guide to the anaesthetic management. The aims of the latter may be summarized as the "Rule of 100": systolic blood pressure > 100 mmHg, urine output > 100 ml · hr-1, PaO2 > 100 mmHg, haemoglobin concentration > 100 g · L-1. Common management problems hypotension, arrhythmias, diabetes insipidus, oliguria, and coagulopathy) are discussed in detail. The intraoperative management of the brain-dead organ donor provides the anaesthetist with the challenge of a major surgical procedure in a subject with important physiological derangements. © 1990 Canadian Anesthesiologists.