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Improving oxygenation when conventional ventilation fails: a case study.

Long periods of significant hypoxia do not disqualify a patient from becoming an organ donor. As the management of organ donor patients becomes more complex, recovery coordinators often have to change their thinking and resort to nonconventional means of management. This case study presents a hypoxic donor and how using pressure-control inverse ratio ventilation improved oxygenation in this donor. Before changing ventilator modes, the transplant surgeons were concerned about the long periods of hypoxia the patient had experienced during her hospitalization. After making the change, improving oxygenation, and demonstrating an improved oxygen state, 4 organs were recovered and subsequently transplanted. All the recovered organs functioned immediately after transplantation without any signs of poor performance. Although this treatment modality is not available at every institution, it can be used to improve oxygenation problems in organ donors.