DDePICt
Determination of Death Practices in Intensive Care Research Program
INVESTIGATORS: Sonny Dhanani, Laura Hornby, Amanda van Beinum, Nathan Scales, Sam Shemie
BACKGROUND
The demand for transplantable organs continues to out-pace the supply. The recent standard has been the ability to donate organs only after neurologic determination of death. Due to improved technologies for organ preservation and international shortages of organ donors, reconsideration of donation after circulatory determination of death (DCD) has progressively occurred. There is accepted medical practice for determination of neurologic death but there are no such standards for the determination of death after cardiac arrest. Until DCD, there has been little need for the medical community to concern itself with the timing of a patient’s death after cardiac arrest. Without clarity, current DCD protocols in Canada and internationally may be perceived to violate the “dead donor rule” and compromise patient welfare. As an immediate consequence of death, organ donation mandates clarity and consistency in the diagnostic criteria used to determine death after cardiac arrest.
The “Determination of Death Practices in Intensive Care” (DDePICt) Research Program is a dedicated group of clinicians and researchers aiming to address these concerns and move towards standards for determination of death and procedure standards for donation after circulatory determination of death in Canada.
CORE PROGRAM OBJECTIVES
1. To describe the current understanding and practice of the determination of death after cardiac arrest.
2. To describe the current understanding of the limits of resuscitability of the heart and brain under normothermic conditions.
3. To evaluate the determinants of death after cardiac arrest using non-invasive and invasive monitoring technology.
4. To develop and implement standards for the determination of cardiac death for the purposes of organ donation after cardiac death in Canada
BACKGROUND
The demand for transplantable organs continues to out-pace the supply. The recent standard has been the ability to donate organs only after neurologic determination of death. Due to improved technologies for organ preservation and international shortages of organ donors, reconsideration of donation after circulatory determination of death (DCD) has progressively occurred. There is accepted medical practice for determination of neurologic death but there are no such standards for the determination of death after cardiac arrest. Until DCD, there has been little need for the medical community to concern itself with the timing of a patient’s death after cardiac arrest. Without clarity, current DCD protocols in Canada and internationally may be perceived to violate the “dead donor rule” and compromise patient welfare. As an immediate consequence of death, organ donation mandates clarity and consistency in the diagnostic criteria used to determine death after cardiac arrest.
The “Determination of Death Practices in Intensive Care” (DDePICt) Research Program is a dedicated group of clinicians and researchers aiming to address these concerns and move towards standards for determination of death and procedure standards for donation after circulatory determination of death in Canada.
CORE PROGRAM OBJECTIVES
1. To describe the current understanding and practice of the determination of death after cardiac arrest.
2. To describe the current understanding of the limits of resuscitability of the heart and brain under normothermic conditions.
3. To evaluate the determinants of death after cardiac arrest using non-invasive and invasive monitoring technology.
4. To develop and implement standards for the determination of cardiac death for the purposes of organ donation after cardiac death in Canada
The DDePICt Research Program Outline:
