*Surgical Techniques of Multiorgan Procurement from a Deceased Donor DOI: http://dx.doi.org/10.5772/intechopen.94156*

Every effort should be done to maintain PaO2 > 100 mmHg, SpO2 > 95%, PaCO2 between 35 and 40 mmHg and pH between 7.35 and 7.45 by using lung protective strategy including avoidance of excessive intravenous fluids, minimal tidal volume (8–12/minute) and lowest FiO2 [12].

For hormonal management, intravenous infusion of 1000 mg (15 mg/kg) methylprednisolone succinate, insulin (target glucose level of 80–150 mg/dl), vasopressin 0.5–4 U/h) or intranasal desmopressin (1–2 puff every 6 hours) and thyroxine replacement (4 mcg/h) is the standard of treatment to reduce the systemic inflammatory response in these patients and maintaining the hemodynamic stability of them [10].

Urine output is better maintained between 100 and 300 ml/hour to prevent hypo or hypernatremia. Potassium (K+ ) replacement should be started when serum potassium level is reduced (target K+ level 3.5–4.5 meq/l). Lactated ringer's solution or half saline solution is the best available fluid for these patients and using colloids such as albumin should be avoided [13].

Body temperature should be maintained over 35.8°C [13] for better cardiac function and prevention of coagulation cascade and hypoxic tissue damage. To reduce cardiac arrhythmias maintaining normal body temperature, hemodynamics, electrolyte, hemoglobin levels over 10 g/dl and minimal use of vasopressors is essential. Calcium, phosphorus and magnesium also should be maintained at physiologic level to prevent cardiac arrhythmias during the surgery [14].
