提高器官捐献中生命维持措施撤停的质量：框架和实施工具包。
Improving quality of withdrawal of life-sustaining measures in organ donation: a framework and implementation toolkit.
机构信息
Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Trillium Gift of Life Network, Toronto, ON, Canada.
出版信息
Can J Anaesth. 2020 Nov;67(11):1549-1556. doi: 10.1007/s12630-020-01774-6. Epub 2020 Sep 11.
BACKGROUND
Donation after circulatory determination of death (DCD) is responsible for the largest increase in deceased donation over the past decade. When the Canadian DCD guideline was published in 2006, it included recommendations to create standard policies and procedures for withdrawal of life-sustaining measures (WLSM) as well as quality assurance frameworks for this practice. In 2016, the Canadian Critical Care Society produced a guideline for WLSM that requires modifications to facilitate implementation when DCD is part of the end-of-life care plan.
METHODS
A pan-Canadian multidisciplinary collaborative was convened to examine the existing guideline framework and to create tools to put the existing guideline into practice in centres that practice DCD.
RESULTS
A set of guiding principles for implementation of the guideline in DCD practice were produced using an iterative, consensus-based approach followed by development of four implementation tools and three quality assurance and audit tools.
CONCLUSIONS
The tools developed will aid DCD centres in fulsomely adapting the Canadian Critical Care Society Withdrawal of Life-Sustaining Measures guideline.
背景
循环死亡判定后的捐献（DCD）在过去十年中导致了死亡捐献的最大增长。2006 年发布加拿大 DCD 指南时，其中包括制定有关停止生命支持措施（WLSM）的标准政策和程序以及该实践质量保证框架的建议。2016 年，加拿大重症监护学会制定了 WLSM 指南，该指南要求进行修改，以促进在 DCD 作为临终关怀计划的一部分时实施。
方法
召集了一个全加多学科合作团队，以检查现有的指南框架，并创建工具，以便在实施 DCD 的中心实施现有指南。
结果
使用迭代的、基于共识的方法制定了一套用于在 DCD 实践中实施指南的指导原则，随后开发了四个实施工具以及三个质量保证和审计工具。
结论
开发的工具将有助于 DCD 中心全面适应加拿大重症监护学会的《停止生命支持措施指南》。
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