Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Benchmarking performance in organ donation programs: dependence on demographics and mortality rates.
Donors whose diagnosis of death is based upon neurologic criteria are the primary source of organs for human transplantation. The current measure of effectiveness of organ donation programs is the crude statistic, donors per million population (DPMP). This statistic represents the number of available donors, divided by the potential donor population. Comparisons between transplantation programs are done using the DPMP statistic. We sought to determine if variance in organ donation rates, reported as DPMP could be accounted for by differences in population demographics, specifically age and gender-specific mortality rates. ⋯ These results bring into question the reliability of using crude DPMP as a measure of organ and tissue donation program performance. Alternative measures of benchmarking performance in organ donation programs should be considered.
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Comparative organ donation rates are expressed per million population and by this measurement, Canada lags behind other countries. These estimates do not account for differing demographics and health patterns of populations which can result in different rates of death by neurological criteria and subsequent donation rates. We sought to measure directly the number of deaths by neurological criteria, the associated donation rates, and the reasons for the differences. ⋯ There is substantial geographic variability in the rate of neurological death and actual organ donation rates in these Canadian tertiary care centres. These variations are principally related to regional differences in demographics of brain injury, referral patterns and donation consent rates, rather than lack of identification of potential donors.
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Randomized Controlled Trial
Intraoperative infusion of dexmedetomidine reduces perioperative analgesic requirements.
This prospective, randomized, double-blind study was designed to assess whether intraoperative infusion of dexmedetomidine provides effective postoperative analgesia. Postoperative pain scores and morphine consumption were compared in a treated group and a placebo group, both of which received patient-controlled morphine after total abdominal hysterectomy. ⋯ Continuous iv dexmedetomidine during abdominal surgery provides effective postoperative analgesia, and reduces postoperative morphine requirements without increasing the incidence of side effects.