Expanding the pool of deceased organ donors: the ICU and beyond

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Electrophysiologic monitoring in neurointensive care

Cumulative evidence of potential benefits of electroencephalography (EEG) and evoked potentials in the management of patients with acute cerebral damage has been confirmed. Continuous EEG monitoring is the best method for detecting nonconvulsive seizures and is strongly recommended for the treatment of status epilepticus. Continuously displayed, validated quantitative EEG may facilitate early detection of secondary cerebral insults and may play a decision-making role in the management of patients with head injury, stroke, or subarachnoid hemorrhage. Long-latency auditory evoked potentials and cognitive components constitute a new field of interest for the progress of comatose patients. Motor evoked potentials may become clinically important both in acutely injured and elective postoperative patients. In the neurointensive care units adequate techniques can be selected to answer targeted clinical questions. The efficacy can be improved by implementing educational projects based on ad hoc training of nurses and neurointensive care specialists

Attitude, intention and will expression on post-mortem organ donation in the Italian population

Background: More than 8000 people are waiting for organ transplantation in Italy. Even though most of the population has a positive attitude towards organ donation, the percentage of consent to donation remains low (only 68.2% of the expressions in 2021). Exploring different points of view and variables that might play a role in this process is very important to foster a culture of organ donation and specific policy implementation. Methods: A mixed-method study was conducted in 2021 in collaboration with the National Centre for Transplantation and involved 353 participants (healthcare professionals, citizens, opinion leaders, registry office employees) that completed a questionnaire to assess their attitudes towards organ donation and will expression before and after participating to a focus group on the topic. Statistical analyses were conducted with SPSS. Findings: Results showed that 93.8% of participants reported a positive attitude towards donation, which significantly increased participating in the focus group (p<.001). Only 50.4% of the sample expressed their will at the time of the study. Significant correlations were found between a positive attitude and being a woman (p <.045), higher education (p<.004), familiarity with donation (p<.001); and between having expressed one’s will and familiarity with donation (p <.024) and being registered to donation associations (p<.001). Discussion: Differences in attitude and will expression in each group (especially opinion leaders and registry office employees) underline the need to implement targeted interventions and policies to foster the creation of a culture of donation and to support citizens in expressing their will consciously

Life beyond life: Perceptions of post-mortem organ donation and consent to donate-A focus group study in Italy

Objectives: Many factors such as personal and cultural beliefs, misinformation, fear of death and inadequate will registering procedures can influence post-mortem organ donation. The present study aimed to explore the perceptions, beliefs and information around post-mortem donation and will expression in different groups of the Italian population, to orient future interventions and raise awareness.Design: Qualitative research with focus groups.Methods: A total of 38 focus groups involving 353 participants including the general population (young adults: 18-39, mature adults: 40-70), local and hospital health professionals, critical area health professionals (emergency room and intensive care), registry office employees and opinion leaders, were conducted in six regions from different parts of Italy between June and November 2021. Thematic analysis was conducted with the use of Atlas.ti9.Results: Five overarching themes were identified: dilemmas regarding donation, resistance to donation, facilitators of donation, difficulties in terms of will expression and proposals to encourage will expression. Possible facilitators were having personal and professional experiences with organ donation, feeling useful for society, having reliable information and trust in the health care system. Potential barriers to donation were doubts and fears about brain death, bodily integrity concerns, religious beliefs, misinformation and distrust in the health care system.Conclusions: These results highlighted the significance of a bottom-up perspective with regard to identifying the personal perceptions and beliefs with regard to donation, underlining the urgency of creating tailored interventions to sensitize different groups of the population in terms of promoting an informed choice and a culture of donation

Organ Donation: Perception and Will Expression in the Italian Population

This study investigates the perception of organ donation and will expression in the Italian population, using focus groups in order to develop better intervention and campaign to raise awareness