Intraoperative management of a brain-dead organ donor with a beating heart includes administration of all the following medications except:
Adequate oxygen delivery is the primary goal in maintaining viability of the organs in a brain-dead organ donor. A balance must be struck between treating hypovolemia caused by the loss of central autoregulation and the occurrence of diabetes insipidus and excessive organ congestion caused by hypervolemia.
The anesthetic management of the brain-dead donor may include neuromuscular blockade, management of hypertension secondary to surgical stimulation and control of the systemic inflammatory response associated with brain death. Movement in response to surgical stimulation is a spinal reflex that can be prevented by the administration of neuromuscular blocking agents. Surgical stimulation produces increased catecholamine concentrations that may be treated with volatile anesthetic agents, opioids or vasodilators.
Steroid therapy in brain-dead donors has been...