[Hemodynamic, coagulation and glycoregulation changes induced by brain death]

Ann Fr Anesth Reanim. 1990;9(2):115-22. doi: 10.1016/s0750-7658(05)80049-8.
[Article in French]

Abstract

Brain death results in various changes in circulation haemostasis, acid-base balance and glycoregulation. This study was carried out between February 1988 and December 1988 in 91 patients with brain death. Age range was between 6 and 58 years. The cause of brain death was brain trauma (71%) and vascular malformations (26%). In all patients a cardio-vascular collapse occurred at the moment of brain death, requiring an intravascular loading (466.3 +/- 240.3 ml.h-1) with crystalloids and albumin. Dopamine was used in 70% of cases at the dose of 3 micrograms.kg.min-1 to improve kidney and splanchnic perfusion. No alterations of acid-base balance were observed in these patients who admitted for organ donation in a short delay (17.1 +/- 6 h). Haemostasis was modified in all patients but the alterations occurred before the brain death and were related to brain injury. Further investigations are required for a better understanding of glycoregulation changes as they could influence pancreatic transplant survival. Hormonal changes have also to be more extensively studied for possible physiopathologic causes of the variations. A better understanding of these alterations will be of benefit for management of patients in brain death and potential organ donors.

Publication types

  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Blood Coagulation Disorders / physiopathology*
  • Blood Glucose / analysis*
  • Brain Death / physiopathology*
  • Child
  • Female
  • Fibrinogen / analysis
  • Hemodynamics*
  • Humans
  • Hypotension / drug therapy
  • Hypotension / physiopathology
  • Male
  • Middle Aged
  • Platelet Count
  • Prothrombin Time
  • Retrospective Studies
  • Sympathomimetics / therapeutic use
  • Tissue and Organ Procurement / organization & administration

Substances

  • Blood Glucose
  • Sympathomimetics
  • Fibrinogen