Titre
Ethical Issues in the Use of Extracorporeal Membrane Oxygenation in Controlled Donation After Circulatory Determination of Death.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Dalle Ave, A.L.
Auteure/Auteur
Shaw, D.M.
Auteure/Auteur
Bernat, J.L.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1600-6143
Statut éditorial
Publié
Date de publication
2016-08
Volume
16
Numéro
8
Première page
2293
Dernière page/numéro d’article
2299
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
The use of donor extracorporeal membrane oxygenation (ECMO) to improve graft outcomes by some controlled donation after circulatory determination of death (cDCDD) programs raises ethical issues. We reviewed cDCDD protocols using ECMO and the relevant ethics literature to analyze these issues. It is not obvious that ECMO in cDCDD improves graft outcomes. In our opinion, ECMO implemented before death can interfere with end-of-life care and damage bodily integrity. By restoring systemic circulation, ECMO risks invalidating the preceding declaration of death if brain and cardiac perfusion is not adequately excluded because of malfunction or misplacement of the supradiaphragmatic aortic occlusion balloon. The use of ECMO is not compatible with the acronym DCDD because circulation is restored after the determination of death. Because of these deficiencies, we concluded that other techniques are preferable, such as rapid recovery or in situ cold infusion. If ECMO is performed, it requires a specific informed consent and transparency.
PID Serval
serval:BIB_B9F46CE081FB
PMID
Date de création
2016-03-29T12:32:51.894Z
Date de création dans IRIS
2025-05-20T21:18:25Z