Care of the potential pediatric organ donor.
Although all of this information may create the impression that caring for a potential organ donor is an exceedingly complex task, in the authors' experience, this often is not true, and much energy can--and should--be devoted to the care of the bereaved family. Of crucial importance are the early recognition of brain death and the consequent radical switch of the treatment goal from preservation of the patient's brain and life to preservation of organs for the lives of others. Care for the donor is the natural extension of care for a critically ill or injured patient. During the foregoing discussion, the authors had to stress the absence of sound evidence on many points. Because many reports originate from transplant centers dedicated to a specific organ, gaining a comprehensive view on management options in the ICU further is hampered. Thus, this situation leaves another field in which investigations originating from pediatric intensivists could provide evidence urgently needed to make optimal choices. The next decade should see the thyroid hormone controversy solved by at least one controlled prospective study and the differential applicability of inotropic, vasoactive, or fluid-centered strategies. It seems self-evident that only graft survival and related parameters can form adequate endpoints for future studies.
Lutz-Dettinger
N
N
Division of Pediatric Intensive Care, Ghent University Hospital, Ghent, Belgium. nld@yucom.be
de Jaeger
A
A
Kerremans
I
I
D001926:Brain Death / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D020790:Diabetes Insipidus, Neurogenic / Q000175:diagnosis / Q000503:physiopathology; D004569:Electroencephalography; D006801:Humans; D007223:Infant; D007328:Insulin / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D009926:Organ Preservation; D020458:Third-Party Consent; D013963:Thyroid Hormones / Q000627:therapeutic use; D013997:Time Factors; D014019:Tissue Donors
D007328:Insulin; D013963:Thyroid Hormones