[Hemodynamic, coagulation and glycoregulation changes induced by brain death].
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.
Masson
F
F
Département d'Anesthésie-Réanimation, Groupe Hospitalier Pellegrin, Bordeaux.
Thicoïpe
M
M
Maurette
M
M
Pinaquy
C
C
Léger
A
A
Erny
P
P
D000293:Adolescent; D000328:Adult; D001778:Blood Coagulation Disorders / Q000503:physiopathology*; D001786:Blood Glucose / Q000032:analysis*; D001926:Brain Death / Q000503:physiopathology*; D002648:Child; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011517:Prothrombin Time; D012189:Retrospective Studies; D013566:Sympathomimetics / Q000627:therapeutic use; D009927:Tissue and Organ Procurement / Q000458:organization & administration
D001786:Blood Glucose; D013566:Sympathomimetics; D005340:Fibrinogen
Perturbations de l'hémodynamique, de la coagulation et de la glycorégulation induites par la mort cérébrale.