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Open Access 01-11-2016 | Systematic Review

The rate of brain death and organ donation in patients resuscitated from cardiac arrest: a systematic review and meta-analysis

Authors: Claudio Sandroni, Sonia D’Arrigo, Clifton W. Callaway, Alain Cariou, Irina Dragancea, Fabio Silvio Taccone, Massimo Antonelli

Published in: Intensive Care Medicine | Issue 11/2016

Abstract

Background

The occurrence of brain death in patients with hypoxic-ischaemic brain injury after resuscitation from cardiac arrest creates opportunities for organ donation. However, its prevalence is currently unknown.

Methods

Systematic review. MEDLINE via PubMed, ISI Web of Science and the Cochrane Database of Systematic Reviews were searched for eligible studies (2002–2016). The prevalence of brain death in adult patients resuscitated from cardiac arrest and the rate of organ donation among brain dead patients were summarised using a random effect model with double-arcsine transformation. The quality of evidence (QOE) was evaluated according to the GRADE guidelines.

Results

26 studies [16 on conventional cardiopulmonary resuscitation (c-CPR), 10 on extracorporeal CPR (e-CPR)] included a total of 23,388 patients, 1830 of whom developed brain death at a mean time of 3.2 ± 0.4 days after recovery of circulation. The overall prevalence of brain death among patients who died before hospital discharge was 12.6 [10.2–15.2] %. Prevalence was significantly higher in e-CPR vs. c-CPR patients (27.9 [19.7–36.6] vs. 8.3 [6.5–10.4] %; p < 0.0001). The overall rate of organ donation among brain dead patients was 41.8 [20.2–51.0] % (9/26 studies, 1264 patients; range 0–100 %). The QOE was very low for both outcomes.

Conclusions

In patients with hypoxic-ischaemic brain injury following CPR, more than 10 % of deaths were due to brain death. More than 40 % of brain-dead patients could donate organs. Patients who are unconscious after resuscitation from cardiac arrest, especially when resuscitated using e-CPR, should be carefully screened for signs of brain death.

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Title: The rate of brain death and organ donation in patients resuscitated from cardiac arrest: a systematic review and meta-analysis
Authors: Claudio Sandroni
Sonia D’Arrigo
Clifton W. Callaway
Alain Cariou
Irina Dragancea
Fabio Silvio Taccone
Massimo Antonelli
Publication date: 01-11-2016
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 11/2016
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-016-4549-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The rate of brain death and organ donation in patients resuscitated from cardiac arrest: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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