A desproporção entre a grande demanda pela doação de órgãos e a baixa realização de transplantes é um grave problema de saúde pública. O reconhecimento da morte encefálica, a adequada abordagem da família e a manutenção clínica do doador falecido são fundamentais para a diminuição desta desproporção. Neste cenário, o intensivista tem importância central e a aplicação do conjunto de informações disponíveis para manutenção do potencial doador falecido está claramente associada à redução de perdas de doadores e ao aumento da efetivação de transplantes.

Para auxiliar o intensivista neste processo, a AMIB elaborou um conjunto de diretrizes chamadas “Diretrizes Para Manutenção de Múltiplos Órgãos no Potencial Doador Falecido”.

O documento, dividido em três partes, vai contribuir para uniformizar os cuidados prestados ao doador falecido e incrementar quantitativa e qualitativamente o transplante de órgãos com medidas aplicáveis à realidade brasileira.

As Diretrizes apresentam também uma série de esclarecimentos que serão fundamentais para auxiliar o intensivista e sua equipe na manutenção do potencial doador falecido de órgãos a partir do diagnóstico da morte encefálica e abordagem da Ventilação Mecânica, Controle Endócrino Metabólico e Aspectos Hematológico e Infecciosos.

As Diretrizes, iniciativa da AMIB e fruto do trabalho de dezenas de médicos intensivistas de vários estados brasileiros, ainda trazem Recomendações Órgãos-Específicas para a manutenção renal, pulmonar, cardíaca e hepática, destacando as medidas para preservação do órgão, avaliação das principais funções, cuidados essenciais para garantir a transplantabilidade e contra-indicações que podem inviabilizar o transplante.

Para facilitar a compreensão e implantação das informações, os autores das diretrizes classificaram (de acordo com o sistema Grades of Recommendation Assessment, Development and Evaluation) a qualidade das recomendações como:

FORTE – deve ser feito
FRACA – talvez deva ser feito
NÃO ESPECÍFICA – não há vantagens e nem desvantagens

Outro diferencial do documento é sua redação didática e em forma de perguntas e respostas, que facilita a localização das informações e sua consulta.Para que as diretrizes sejam acessíveis aos intensivistas de todo Brasil, uma das ações da AMIB na terceira edição da campanha Orgulho de Ser Intenvista será a distribuição de uma versão de bolso do documento, que também estará disponível para consulta no site da AMIB. (www.amib.org.br)

Na morte encefálica o paciente apresenta situação clínica em que, devido a uma lesão irreversível do cérebro, há coma aperceptivo com ausência de atividade motora supra-espinal e apneia.

Mas, diagnosticar corretamente a morte encefálica é um dos principais desafios do médico intensivista, sendo necessária a realização de exames clíniconeurológicos e um exame gráfico complementar.

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Diretrizes para manutenção de múltiplos órgãos no potencial doador adulto falecido. (adulto)

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Diretrizes para manutenção de múltiplos órgãos no potencial doador adulto falecido. (adulto)

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Referências Bibliográficas:
 

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