Pacing In Organ Donors (the POD Trial)

Inclusion Criteria: * Designated as brain dead according to BC provincial guidelines, and * Are 19 years or older, and * Are mechanically ventilated, and * TSDM consented for organ donation, and * TSDM consented to study participation, and * Accepted by BC transplant team to donate at least 1 organ system, and * Declined by BC transplant team for lung donation based on hypoxia with the PaO2/FiO2ratio \< 300 mmHg or other criterion that precludes lung donation as requested by the organ donation team. Exclusion Criteria: * Greater than 8 hours from time declined for lung donation and initiation of LAPS-PNS, * Inability to place a central venous catheter in the left internal jugular or left subclavian vein, * Neuromuscular disease (e.g., Amyotrophic Lateral Sclerosis, Guillain-Barre), * Previous phrenic nerve injury, * Spinal cord injury above the 6th cervical spine level, * Implanted electronic cardiac or neurostimulation device in situ * 2nd or 3rd degree heart block on at least 2 EKGs conducted during routine care, * Treating physician deems enrollment not clinically appropriate for other reason