The Outcome of Active Identification and Early Resuscitation in Prospective Possible Organ Donor During COVID-19 Pandemic, Udon Thani Hospital
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Abstract
This research is a retrospective study aimed at examining the outcomes of proactive identification, early life-saving efforts, and barriers to organ donation at Udon Thani Hospital, which serves as the central organ donation center for Health Region 8 during the COVID-19 pandemic. The population consisted of patients with brain injuries, and the sample group included 172 patients with severe brain pathology (GCS < 5), selected purposively according to inclusion and exclusion criteria, during the period from October 1, 2020, to March 31, 2022. Data were collected using a patient data recording form, which was quality-checked with an IOC value of 1.00. Descriptive statistics were used for data analysis.
1. The majority of patients (74.41%) were male, with an average age of 47.59 years (SD = 17.88). Brain injury was the primary cause (76.74%) of brain death. The average APACHE II score was 29.71 (SD = 2.30).
2. The transition from possible donor to potential donor occurred within the first 24 hours for 93.02% of cases. Early resuscitation was required for complications, including hypotension (62.79%), diabetes insipidus (41.86%), hypernatremia (11.12%), and prolonged shock in potential donors (1.16%). The mortality rate was 65.11%. Actual and utilized donors accounted for 15 cases (8.72%), with the kidney being the most frequently donated organ. The main reasons for families refusing organ donation were unspecified (69.30), beliefs about the afterlife (8.72%) and a preference for palliative care (22.09%).
Research findings indicate that proactively identifying potential organ donors and initiating life-saving measures early, along with continuous monitoring and follow-up, can increase the likelihood of organ donation and reduce the loss of brain-dead patients before entering the organ donation process. These efforts should consider cultural beliefs and the need for palliative care.
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