Page 43 - Critical Care Notes

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Hemodynamic Management of Potential Brain-Dead
Organ Donors
Ensure adequate intravascular volume and adequate cardiac output to ensure
consistent perfusion to vital organs.
■ MAP >60 mm Hg
■ Urine output >1.0 mL/kg/hr
■ Left ventricular ejection fraction >45%
Nursing Care
■ Fluid management—fluids or diuretics
■ Inotropic agents to correct low cardiac output
■ Vasopressors to correct vasodilatation
■ Thyroid hormone
■ Corticosteroids to reduce inflammation
■ Vasopressin to support renal function
■ Insulin to control glucose levels
■ Regulate ventilator settings including use of PEEP
■ Suction frequently to promote adequate oxygenation
Specific organ donation protocols:

Anxiety, Agitation, and Sedation
Purpose of sedation is to minimize use of neuromuscular paralysis agents. Short-
term use will ↓ ventilatory time, ↓ length of stay in ICU, ↓ costs, lead to fewer
tracheostomies, and provide early intervention of neurological deterioration.

BASICS