The following is a summary of “Evidence-Based Checklist to Delay Cardiac Arrest in Brain-Dead Potential Organ Donors: The DONORS Cluster Randomized Clinical Trial,” published in the December 2023 issue of Critical Care Medicine by Westphal et al.
For a study, researchers assessed a checklist’s effectiveness in managing brain-dead potential donors in ICUs. The DONORS trial that happened from June 2017 to November 2019 included hospital ICUs with over 10 brain deaths in 2 years. Enrollees, aged 14 to 90, were those consistent with brain death after initial examination. They were split into intervention and control groups. Data analysis occurred from June to August 2020.
In the study, the main aim was to prevent brain-dead potential donors from experiencing cardiac arrest. Out of 1,771 donors screened across 63 hospitals, 1,535 were included, with a median age of 51. Most injuries were due to stroke (57.1%), followed by trauma (31.6%). Hospitals were split: 31 (49.2%) to the intervention group and 32 (50.8%) to the control. Although not statistically significant, there was a lower rate of cardiac arrests in the intervention group (9.4%) compared to the control (14.8%). Yet, high adherence to the checklist notably reduced cardiac arrest rates (5.3% vs 14.8%).
In the clinical trial, cluster randomization didn’t decisively show that implementing an evidence-based checklist effectively reduces brain-dead donor loss to cardiac arrest. Results suggest the checklist might be ineffective unless the recommended actions are consistently followed.
Source: jamanetwork.com/journals/jamanetworkopen/fullarticle/2812886