Hansen P B, Thisted B K, Andersen L W, Larsen B, Jansen E C, Secher N H
Anaestesiafdelingen, Rigshospitalet, København.
Ugeskr Laeger. 1992 Apr 20;154(17):1172-6.
As of July 1990 brain death was legally recognized in Denmark thereby rendering transplantation of heart, liver and lung possible. Brain death donors are usually treated in neurosurgical or anaesthetic intensive care units. The staff of these units influence the number of donors and also the quality of organs donated. Physiological factors pertinent to brain death donors and pre- and peroperative donor therapy in relation to multiorgan procurement are discussed from the viewpoint of the anaesthetist. Symptomatic therapy aimed at optimizing and maintaining organ function is employed; thus continuing intensive care. Sympathetic and somatic reflex responses to surgical stimulation are to be anticipated, often necessitating analgesics to blunt haemodynamic responses and neuromuscular blocking agents to inhibit movements and/or rigidity.
截至1990年7月,丹麦在法律上承认脑死亡,从而使心脏、肝脏和肺的移植成为可能。脑死亡供体通常在神经外科或麻醉重症监护病房接受治疗。这些病房的工作人员会影响供体的数量以及所捐赠器官的质量。本文从麻醉医生的角度讨论了与脑死亡供体相关的生理因素以及与多器官获取相关的术前和术中供体治疗。采用旨在优化和维持器官功能的对症治疗;因此需要持续的重症监护。预计会出现对手术刺激的交感神经和躯体反射反应,这通常需要使用镇痛药来减弱血流动力学反应,并使用神经肌肉阻滞剂来抑制运动和/或强直。