cDCDD和心脏采购:来自法国重症监护视角的挑战
Matthieu Le Dorze1,2, Julien Charpentier3, Gaëlle Cheisson4
1Université Paris Cité, INSERM U942 MASCOT, Paris, France.
概括
循环死亡后的受控捐赠 (cDCDD) 为增加器官可用性提供了一个有希望的途径. 本文讨论了cDCDD中心脏采购的关键护理挑战和伦理考虑,以确保信任和遵守死亡捐赠者的规则.
科学领域:
- 医学伦理 医学伦理
- 密集护理医学 密集护理医学
- 器官移植 器官移植
背景情况:
- 循环死亡确定后的受控捐赠 (cDCDD) 是提高器官可用性的关键策略.
- 自2015年以来,法国一直使用国家cDCDD协议与腹部正常热区域输液 (A-NRP).
- 对于cDCDD捐赠者的心脏采购潜力已经促使新的临床和伦理讨论.
研究的目的:
- 从cDCDD捐赠者的心脏采购的不断变化的实践提供关键护理的观点.
- 确定和解决与取消维持生命措施 (WLSM) 和常温区域 perfusion (NRP) 相关的关键挑战.
- 确保符合道德标准,并保持公众对cDCDD途径的信任.
主要方法:
- 这份立场论文得到了法国两家重症监护协会的认可.
- 它批判性地检查了搬迁WLSM对心脏采购的影响.
- 它解决了有关NRP期间死亡的永久性和遵守死亡捐赠者规则的担忧.
主要成果:
- 心脏采购可能需要在ICU外发生WLSM,这挑战了法国目前的做法.
- 密集主义者强调在ICU中保持WLSM,并在搬迁期间确保护理的连续性.
- 通过研究和强有力的道德框架,人们对NRP和死亡捐赠者的担忧可以得到缓解.
结论:
- 保持基于ICU的WLSM是首选的,重点是患者的护理连续性,如果搬迁是必要的.
- 强有力的伦理准则和生物医学研究对于解决有关死亡声明和NRP的担忧至关重要.
- 对这些挑战的透明讨论对于维持对cDCDD的信任至关重要.
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