Erişkin Hastada Donör ve Potansiyel Donör Bakımı
Özet
Organ donör bakımı, beyin ölümü kesinleşmiş potansiyel donörlerin erken tespiti ve yoğun bakım ünitelerinde organ fonksiyonlarının korunmasını amaçlayan hayati bir süreçtir. Standartlaştırılmış protokollerin uygulanması, ailelerin bağış onay oranını artırırken dolaşım durması nedeniyle donör kaybını azaltır. Beyin ölümü sonrasında kafa içi basıncın artmasıyla tetiklenen katekolamin fırtınası, ciddi hemodinamik dalgalanmalara, miyokardiyal hasara ve ardından derin hipotansiyona yol açar. Bu süreçte ortaya çıkan diabetes insipidus, hipernatremi, hipotermi, koagülopati ve akciğer hasarı gibi fizyopatolojik değişikliklerin yakından izlenmesi gerekir. Çoklu organ yönetiminde sıvı resüsitasyonu, vazopressör kullanımı, hormon replasman tedavileri ve koruyucu mekanik ventilasyon stratejileri titizlikle dengelenmelidir. Ayrıca bulaşıcı hastalık taramaları ve enfeksiyon yönetimi aksatılmamalıdır. Organ alımı ameliyatında ise anestezi yönetimiyle donörün vital fonksiyonları korunarak süreç tamamlanır.
Organ donor care is a vital process aiming for the early detection of potential donors with confirmed brain death and the preservation of organ functions in intensive care units. Implementing standardized protocols increases family consent rates while reducing donor loss due to circulatory arrest. The catecholamine storm triggered by increased intracranial pressure after brain death leads to severe hemodynamic fluctuations, myocardial damage, and subsequent profound hypotension. Pathophysiological changes arising during this process, such as diabetes insipidus, hypernatremia, hypothermia, coagulopathy, and lung injury, must be closely monitored. In multiorgan management, fluid resuscitation, vasopressor use, hormone replacement therapies, and protective mechanical ventilation strategies must be meticulously balanced. Additionally, infectious disease screenings and infection management should not be neglected. Finally, during the organ recovery surgery, the process is completed under anesthesia management by preserving the donor's vital functions.
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