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供者(优化器官获取网络研究):一项评价在 ICU 中对脑死亡潜在器官捐献者管理实施基于证据的检查表的方案,一项整群随机试验。

DONORS (Donation Network to Optimise Organ Recovery Study): Study protocol to evaluate the implementation of an evidence-based checklist for brain-dead potential organ donor management in intensive care units, a cluster randomised trial.

机构信息

Research Projects Office, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil.

Hospital Municipal São José, Joinville, Santa Catarina, Brazil.

出版信息

BMJ Open. 2019 Jun 25;9(6):e028570. doi: 10.1136/bmjopen-2018-028570.

Abstract

INTRODUCTION

There is an increasing demand for multi-organ donors for organ transplantation programmes. This study protocol describes the Donation Network to Optimise Organ Recovery Study, a planned cluster randomised controlled trial that aims to evaluate the effectiveness of the implementation of an evidence-based, goal-directed checklist for brain-dead potential organ donor management in intensive care units (ICUs) in reducing the loss of potential donors due to cardiac arrest.

METHODS AND ANALYSIS

The study will include ICUs of at least 60 Brazilian sites with an average of ≥10 annual notifications of valid potential organ donors. Hospitals will be randomly assigned (with a 1:1 allocation ratio) to the intervention group, which will involve the implementation of an evidence-based, goal-directed checklist for potential organ donor maintenance, or the control group, which will maintain the usual care practices of the ICU. Team members from all participating ICUs will receive training on how to conduct family interviews for organ donation. The primary outcome will be loss of potential donors due to cardiac arrest. Secondary outcomes will include the number of actual organ donors and the number of organs recovered per actual donor.

ETHICS AND DISSEMINATION

The institutional review board (IRB) of the coordinating centre and of each participating site individually approved the study. We requested a waiver of informed consent for the IRB of each site. Study results will be disseminated to the general medical community through publications in peer-reviewed medical journals.

TRIAL REGISTRATION NUMBER

NCT03179020; Pre-results.

摘要

简介

器官移植项目对多器官供体的需求日益增加。本研究方案描述了一项计划中的整群随机对照试验,旨在评估在重症监护病房(ICU)中实施基于证据的、针对脑死亡潜在器官供体管理的目标导向检查表对减少因心脏骤停而导致潜在供体损失的有效性。

方法和分析

该研究将包括至少 60 个巴西站点的 ICU,平均每年有≥10 例有效的潜在器官供体通知。医院将被随机分配(1:1 分配比例)到干预组,该组将实施基于证据的、针对潜在器官供体维护的目标导向检查表,或对照组,将维持 ICU 的常规护理实践。所有参与 ICU 的团队成员都将接受如何进行器官捐献家庭访谈的培训。主要结局将是因心脏骤停而导致潜在供体损失。次要结局将包括实际器官供体的数量和每个实际供体回收的器官数量。

伦理和传播

协调中心和每个参与站点的机构审查委员会(IRB)都批准了该研究。我们请求每个站点的 IRB 豁免知情同意。研究结果将通过在同行评议的医学期刊上发表文章向普通医疗界传播。

试验注册号

NCT03179020;预结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03dd/6597655/18a1d1f2905d/bmjopen-2018-028570f01.jpg

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