I feel that this is a topic that all physios working on ITU should be aware of. I am not sure of any evidence, but I would presume that just because a patient is brain dead they are not immune to the development of nosocomial pneumonia and all the other complications associated with ventilation. I feel it is therefore prudent to continue to treat the patient as you would do if they were not brain dead in the chance that they may become an organ donor. Obviously if they have pre- existing lung disease or damage to the lungs as a result of trauma this would probably exclude use of the lungs for transplant. We have such a small number of organ donors, and even less with suitable lungs that we need to maximise the chance of using lungs for transplant.