Bioética, reanimación cardiopulmonar y donación de órganos en asistolia

  1. Lora Deltoro, Pablo de
  2. Ortega Deballón, Iván María
  3. Rodríguez-Arias Vailhen, David
  4. Seoane, José-Antonio
  5. Serrano, Alfredo
  6. Triviño Caballero, Rosana
Journal:
Dilemata

ISSN: 1989-7022

Year of publication: 2013

Issue Title: Responsabilidades y Justicia Global

Issue: 13

Pages: 283-296

Type: Article

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Abstract

Los llamados protocolos de donación de órgano en asistolia no controlada (DANC) han sido implementados en varios países, como España y Francia, para incrementar la disponibilidad de órganos para trasplante. Permiten la obtención de riñones, hígados y pulmones de pacientes que no sobreviven a una reanimación cardio-pulmonar realizada en contexto extra-hospitalario. De manera simultánea al desarrollo y proliferación reciente de estos protocolos, algunos equipos de emergencias han comenzado a emplear métodos no-convencionales de reanimación cardiopulmonar, con resultados todavía inciertos, pero prometedores. La coexistencia de estas dos posibilidades plantea algunas preguntas: ¿En qué momento deben abandonarse los intentos de salvar a un paciente con paro circulatorio y comenzar a considerarlo como un donante potencial de órganos? ¿Cómo se gestionan los posibles conflictos de lealtades que pueden surgir entre los equipos de emergencias y de extracción? ¿Cómo se debe gestionar la información ofrecida a los familiares de esos pacientes y potenciales donantes de órganos? Este artículo recaba las conclusiones de un seminario en el que un grupo de trabajo interdisciplinar abordó estas cuestiones y otras relacionadas con la DANC y la reanimación cardiopulmonar no-convencional.

Bibliographic References

  • Agostinucci, J. M., M. Ruscev, et al. (2011). “Out-of-hospital use of an automated chest compression device: facilitating access to extracorporeal life support or non-heart-beating organ procurement.” Am J Emerg Med 29(9): 1169-1172.
  • Belohlavek, J., K. Kucera, et al. (2012). “Hyperinvasive approach to out-of hospital cardiac arrest using mechanical chest compression device, prehospital intraarrest cooling, extracorporeal life support and early invasive assessment compared to standard of care. A randomized parallel groups comparative study proposal. “Prague OHCA study”.” J Transl Med 10: 163.
  • Bernat, J. L. (2010). “How the distinction between “irreversible” and “permanent” illuminates circulatory-respiratory death determination.” J Med Philos 35(3): 242-255.
  • Bernat, J. L. (2013). “Determining Death in Uncontrolled DCDD Organ Donors.” Hastings Cent Rep 43(1): 30-33.
  • Bernat, J. L., T. P. Bleck, et al. (2013). “Circulatory Death Determination in Uncontrolled Organ Donors: A Panel Viewpoint.” Ann Emerg Med.
  • Bernat, J. L., A. M. Capron, et al. (2010). “The circulatory-respiratory determination of death in organ donation.” Crit Care Med 38(3): 963-970.
  • Blanco, A. (2012). “El trasplante y la escasez.” Bioética Complutense 11(Junio 2012): 13-15.
  • Boucek, M. M., C. Mashburn, et al. (2008). “Pediatric heart transplantation after declaration of cardiocirculatory death.” N Engl J Med 359(7): 709-714.
  • Bracco, D., N. Noiseux, et al. (2007). “The thin line between life and death.” Intensive Care Med 33(5): 751-754.
  • Breitkreutz, R., F. Walcher, et al. (2007). “Focused echocardiographic evaluation in resuscitation management: concept of an advanced life support-conformed algorithm.” Crit Care Med 35(5 Suppl): S150-161.
  • Cardarelli, M. G., A. J. Young, et al. (2009). “Use of extracorporeal membrane oxygenation for adults in cardiac arrest (E-CPR): a meta-analysis of observational studies.” ASAIO J 55(6): 581-586.
  • Carli, P. (2010) “[Prehospital cardiac arrest and ECMO: state of art].” E-memories de l’Académie Nationale de Chirurgie 9, 10-13.
  • Corsiglia, D. (2007). “Reanimación cardiopulmonar: actualidad y expectativas futuras.” Revista de la Federación Argentina de Cardiología 36(2): 65-69.
  • Dhanani, S., L. Hornby, et al. (2012). “Variability in the determination of death after cardiac arrest: a review of guidelines and statements.” J Intensive Care Med 27(4): 238-252.
  • Doig, C. J. and D. A. Zygun (2008). “(Uncontrolled) donation after cardiac determination of death: a note of caution.” J Law Med Ethics 36(4): 760-765, 610.
  • Domínguez-Gil, B., B. Haase-Kromwijk, et al. (2011). “Current situation of donation after circulatory death in European countries.” Transplant international : official journal of the European Society for Organ Transplantation 24(7): 676-686.
  • Joffe, A. R., J. Carcillo, et al. (2011). “Donation after cardiocirculatory death: a call for a moratorium pending full public disclosure and fully informed consent.” Philosophy, Ethics, and Humanities in Medicine 6(17).
  • Jouffroy, R., L. Lamhaut, et al. (2013). “A new approach for early onset cardiogenic shock in acute colchicine overdose: place of early extracorporeal life support (ECLS)?” Intensive Care Med 39(6): 1163.
  • Lamhaut, L., R. Jouffroy, et al. (2012). “Successful treatment of refractory cardiac arrest by emergency physicians using pre-hospital ECLS.” Resuscitation 83(8): e177-178.
  • Lederer, W., C. Lichtenberger, et al. (2004). “Long-term survival and neurological outcome of patients who received recombinant tissue plasminogen activator during out-of-hospital cardiac arrest.” Resuscitation 61(2): 123-129.
  • Lee, S. W. and Y. S. Hong (2008). “Extracorporeal life-support in patients requiring CPR.” Lancet 372(9638): 512-514.
  • Lyon, R. M. (2012). “Extra-corporeal cardiopulmonary resuscitation--miracle cure or expensive futility?” Resuscitation 83(11): 1311-1312.
  • Marijon, E., W. Bougouin, et al. (2012). “[Sudden death of the adult: do not forget the hidden part of the iceberg!].” Rev Med Interne 33(10): 543-545.
  • Marquis, D. (2010). “Are DCD donors dead?” Hastings Center Report(may-june): 24-30.
  • Mateos-Rodriguez, A., L. Pardillos-Ferrer, et al. (2010). “Kidney transplant function using organs from non-heart-beating donors maintained by mechanical chest compressions.” Resuscitation 81(7): 904-907.
  • Miller, F. G. and R. D. Truog (2011). Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life, Oxford University Press.
  • Morimura, N., T. Sakamoto, et al. (2011). “Extracorporeal cardiopulmonary resuscitation for out-ofhospital cardiac arrest: A review of the Japanese literature.” Resuscitation 82(1): 10-14.
  • Munjal, K. G., S. P. Wall, et al. (2013). “A rationale in support of uncontrolled donation after circulatory determination of death.” Hastings Cent Rep 43(1): 19-26.
  • Nagao, K., K. Kikushima, et al. (2010). “Early induction of hypothermia during cardiac arrest improves neurological outcomes in patients with out-of-hospital cardiac arrest who undergo emergency cardiopulmonary bypass and percutaneous coronary intervention.” Circ J 74(1): 77-85.
  • Nolan, J. P., J. Soar, et al. (2010). “European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary.” Resuscitation 81(10): 1219-1276.
  • Organización Nacional de Trasplantes (2012). [Donación en asistolia en España: situación actual y recomendaciones. Documento de Consenso Nacional 2012].
  • Peek, G. J. (2011). “Community extracorporeal life support for cardiac arrest when should it be used?” Resuscitation 82(9): 1117.
  • Perkins, G. D., S. Brace, et al. (2010). “Mechanical chest-compression devices: current and future roles.” Curr Opin Crit Care 16(3): 203-210.
  • Robertson, J. A. (1999). “The dead donor rule.” Hastings Cent Rep 29(6): 6-14.
  • Rodriguez-Arias, D. and I. O. Deballon (2012). “Protocols for uncontrolled donation after circulatory death.” Lancet 379(9823): 1275-1276.
  • Scolletta, S., F. S. Taccone, et al. (2012). “Intra-arrest hypothermia during cardiac arrest: a systematic review.” Crit Care 16(2): R41.
  • Serrano, A., F. Nogal, et al. (2013). “[Revascularización coronaria durante la resucitación cardiopulmonar. Código Puente].” Medicina Intensiva 37(1): 33-43.
  • Sunde, K. (2008). “Experimental and clinical use of ongoing mechanical cardiopulmonary resuscitation during angiography and percutaneous coronary intervention.” Crit Care Med 36(11 Suppl): S405- 408.
  • Tenaillon, A. (2009). “[Uncontrolled donor after cardiac death, ethical aspects] “ Le Courrier de la Transplantation(9): 50-58.
  • Thuong, M. (2011). “Recommandations sur l’information et l’abord des proches des donneurs potentiels d’organes et de tissus décédés après arrêt cardiaque (DDAC), dans l’optique d’un prélèvement “ Ann. Fr. Med.Urgence 1: 438-441.
  • Vanden Hoek, T. L., L. J. Morrison, et al. (2010). “Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.” Circulation 122(18 Suppl 3): S829-861.
  • Wall, S. P., B. J. Kaufman, et al. (2011). “Derivation of the Uncontrolled Donation after Circulatory Determination of Death Protocol for New York City.” Am J Transplant 11(7): 1417-1426.
  • Yang, C. L., J. Wen, et al. (2012). “Cardiocerebral resuscitation vs cardiopulmonary resuscitation for cardiac arrest: a systematic review.” Am J Emerg Med 30(5): 784-793.
  • Youngner, S. J., R. M. Arnold, et al. (1999). “When is “dead”?” Hastings Cent Rep 29(6): 14-21.
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