ORGAN DONATION CRITERIA
Refer imminent deaths of ventilator patients within one hour of patient meeting either of the following criteria:
• PLAN TO DISCUSS WITHDRAWAL OF SUPPORT WITH FAMILY (potential candidate for Donation after Circulatory Death)
• Severe brain injury, ventilator-dependent and GCS< 5
• PLAN TO DISCUSS WITHDRAWAL OF SUPPORT WITH FAMILY (potential candidate for Donation after Circulatory Death)
• Severe brain injury, ventilator-dependent and GCS< 5
BRAIN DEATH DETERMINATION
• Known cause of condition.
• No drug intoxication or significant metabolic disturbances.
• No response to painful stimuli.
• No gag, cough or corneal reflexes.
• Pupils fixed and dilated.
• No spontaneous respiration or movements.
• No drug intoxication or significant metabolic disturbances.
• No response to painful stimuli.
• No gag, cough or corneal reflexes.
• Pupils fixed and dilated.
• No spontaneous respiration or movements.
APNEA TESTING 1
Prerequisite
• Core temperature > 36.5° C or 97° F.
• Systolic blood pressure > 90 mmHg.
• Euvolemia.Option: Positive fluid balance in previous 6 hours.
• Normal PCO2. Option: Arterial PCO2 > 40 mmHg.
• Normal PO2. Option: Preoxygenate to obtain arterial PO2 > 200 mmHg.
Test
• Connect pulse oximeter and disconnect ventilator. Option: Place cannula at level of carina and deliver 100% 02 @8L/min.
• Observe for respiratory movements.
• Draw ABG and reconnect ventilator after approximately 8 minutes.
• Apnea test is positive if no respiratory movement and PCO2 is > 60 mmHg or 20 mmHg increase in PCO2 over baseline
normal PCO2.
• Connect the ventilator if systolic blood pressure becomes < 90 mmHg or pulse oximeter indicates significant 02 desaturation and
arrhythmias develop. Immediately draw ABG.
1 Adopted from American Academy of Neurology Practice Parameters for Determining Brain Death in Adults.
• Core temperature > 36.5° C or 97° F.
• Systolic blood pressure > 90 mmHg.
• Euvolemia.Option: Positive fluid balance in previous 6 hours.
• Normal PCO2. Option: Arterial PCO2 > 40 mmHg.
• Normal PO2. Option: Preoxygenate to obtain arterial PO2 > 200 mmHg.
Test
• Connect pulse oximeter and disconnect ventilator. Option: Place cannula at level of carina and deliver 100% 02 @8L/min.
• Observe for respiratory movements.
• Draw ABG and reconnect ventilator after approximately 8 minutes.
• Apnea test is positive if no respiratory movement and PCO2 is > 60 mmHg or 20 mmHg increase in PCO2 over baseline
normal PCO2.
• Connect the ventilator if systolic blood pressure becomes < 90 mmHg or pulse oximeter indicates significant 02 desaturation and
arrhythmias develop. Immediately draw ABG.
1 Adopted from American Academy of Neurology Practice Parameters for Determining Brain Death in Adults.
GLASGOW COMA SCALE
PUPIL GAUGE (mm)
