器官捐赠在控制无菌和生命结束护理:一个新的伦理现实在重症监护

Rubén Darío Camargo Rubio
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引用次数: 0

摘要

脑或神经死亡的器官捐赠是一种公认的科学和道德程序,然而,对移植的需求超过了器官的供应,不得不求助于其他形式的捐赠。所谓的非心脏跳动供者在文献中被描述为不受控的心脏停止跳动供者和受控的心脏停止跳动供者,在重症监护病房内外被检测到。由于取得了良好的结果,这种获得器官的新方法正在成为世界上越来越被接受的方法。临终关怀的重症监护医生需要了解这种在即将死亡的患者中检测捐赠者的新方法,这些患者患有马斯特里赫特III类晚期灾难性疾病。在病人或家属在遗嘱中决定捐赠之前,必须考虑到知情、代位同意、预先指示、自主、尊重尊严、权利、有控制地撤回生命支持、最后拔管和循环停止的愿景。为了了解受控停搏、临终关怀和重症监护中的伦理问题,使用Medline/PubMed中的ask Medline搜索工具进行了系统综述,并回答了与搜索相关的三个PICO问题。根据参考文献建立了生命终结和DAC以及伦理方面和DAC中使用的术语概念。本综述的目的是了解在控制心脏骤停、临终关怀中器官捐赠的相关因素及其在重症监护中的伦理问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Donación de órganos en asistolia controlada y cuidados del final de vida: Una nueva realidad ética en cuidado intensivo

Organ donation in brain or neurological death is an accepted scientific and ethical procedure, however, the demand for transplants exceeds the supply of organs, having to resort to other forms of donation. To the so-called non-heart-beating donors described in the literature as uncontrolled asystolic donors and controlled asystolic donors, detected inside and outside the intensive care units. This new way of obtaining organs is becoming an increasingly accepted method in the world, due to the favorable results obtained.

The intensive care physician in end-of-life care requires knowledge of this new way of detecting donors in patients in imminent death with terminal catastrophic illness category Maastricht III. Where the vision of informed, subrogated consent, advance directives, autonomy, respect for dignity, rights, controlled withdrawal of life support, terminal extubation and circulatory arrest, must be taken into account before the decision of the patient or family member in their will to donate. To understand donors in controlled asystole, end-of-life care, and ethical issues in intensive care, a systematic review was performed using the ask Medline search tool in Medline/PubMed and three PICO questions related to the search were answered. Concepts of the terms used in end of life and DAC and ethical aspects and DAC were established according to the references.

The objective of this review was to know what is related to organ donation in controlled asystole, end-of-life care and its ethical aspects in intensive care.

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