Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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The demand for donor organs continues to exceed the number of organs available for transplantation. The assistance to the family members of a potential donor in forefront of transplantation is as much important as to maintain donor organ function. Caring for a brain dead potential organ donor is therefore major challenge for nurses and physicians. ⋯ The management of potential organ donors is similar to the management of patients with severe sepsis. The main goal of that treatment is to achieve hemodynamic stability as well as the normalization of endocrine and metabolic disturbances. Donor optimization leads to increased organ procurement and contributes to improved organ function in the recipient.
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Despite of some discussion, there is general acceptance of the brain death criterion. As for Germany, there is a quasi legal regulation (TPG §16): two physicians with a longstanding experience in the management of patients with severe brain lesions are personally responsive for the diagnostic procedure lege artis. ⋯ Nevertheless, discussions on brain death should not be instrumentalized by circumstances of organ explantation. Brain death should be part of a good educational background, to anticipate reflections free from the emotional binding of an acute incident.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2012
[Mental disorders in intensive care medicine - part 1: Principles and diagnostics].
This two-part article on mental disorders in intensive care medicine aims to provide an understanding of the most frequent mental disorders in critical care medicine. Part 1 highlights the basic principles, disturbances and diagnostics and part 2 deals with prevention and therapeutic approaches. ⋯ The consequences thereof include increased morbidity, mortality, and duration of hospitalization. The early participation of a psychiatrist in the diagnostic process is to be recommended.