sedationstation

Surgeon Anthony Atala demonstrates an early-stage experiment that could someday solve the organ-donor problem: a 3D printer that uses living cells to output a transplantable kidney. Follow the link to watch the  lecture                                                                                    Watch-click here

Physiological derangements after brain death are an extension of those which occur with severe brain injury. Initial dysautonomia and catecholamine release -> labile HT and tachycardias Subsequent hypotension due to neurogenic decrease in SVR and / or myocardial dysfunction Neurogenic diabetes insipidus Non-cardiogenic pulmonary oedema Hyperglycaemia Coagulopathy Poikilothermia Management includes a) Ventilatory control: Optimum ventilation strategy uncertain. Recommended aims: ·PaO2 > 100mmHg ·PaO2:FiO2 > 250 ·PaCO2 35 - 45mmHg ·Avoid pulmonary congestion ·Methylprednisone 15mg/kg may improve oxygenation ·Regular routine turning and tracheal toilet b) Circulatory control: ·Volume replacement - crystalloids tend to pulmonary oedema, starch compounds impair graft function ·Inotrope support . Adrenalin promotes hyperglycaemia, but may reduce acute graft rejection.Dobutamine ineffective. ·Short acting ß-Blocker may be used for significant tachycardias. Clonidine w...