DCD 1010 (PILOT STUDY): Validation Of A Spontaneous Breathing Test To Better Predict Time To Circulatory Death In Organ Donation Candidates (Safety And Feasibility Study)

When a patient in intensive care has devastating brain injury and is not going to recover, their family may decide to withdraw life-sustaining treatment and allow a natural death — sometimes with the hope of donating organs to help others. This type of organ donation after circulatory death (DCD) requires the patient to stop breathing and the heart to stop within a specific time window (typically 90 minutes) to ensure the organs remain viable for transplantation. Currently, predicting which patients will die within that 90-minute window is difficult and inexact, which can mean some donation opportunities are missed. This pilot study is testing a simple 10-minute "spontaneous breathing test" — called the DCD 10-10 test — performed at the bedside to assess whether a patient still has any spontaneous breathing drive. Researchers believe this may help predict more accurately which patients are likely to die within the required timeframe. This study involves critically ill adults (18 and older) who are on mechanical ventilation, have a very low level of consciousness, and whose families have already consented to DCD organ donation. The test is being evaluated primarily for safety and feasibility in this sensitive and ethically important setting.