Advancing the science of organ donor management
| العنوان: | Advancing the science of organ donor management |
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| المؤلفون: | Sonny Dhanani, Sam D. Shemie |
| المصدر: | Critical Care |
| بيانات النشر: | BioMed Central, 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Brain Death, Tissue and Organ Procurement, Hydrocortisone, Vasopressins, Best practice, Resuscitation, Declaration, Anti-Inflammatory Agents, Kaplan-Meier Estimate, Critical Care and Intensive Care Medicine, Rigour, Statistics, Nonparametric, Medicine, Humans, Vasoconstrictor Agents, In patient, Organ donation, Prospective Studies, Intensive care medicine, Donor management, Aged, Nordefrin, business.industry, Hemodynamics, Shock, Middle Aged, Tissue Donors, Logistic Models, Donation, Commentary, Observational study, Female, France, business |
| الوصف: | Circulatory failure during brain death organ donor resuscitation is a problem that compromises recovery of organs. Combined administration of steroid, thyroxine and vasopressin has been proposed to optimize the management of brain deceased donors before recovery of organs. However the single administration of hydrocortisone has not been rigorously evaluated in any trial.In this prospective multicenter cluster study, 259 subjects were included. Administration of low-dose steroids composed the steroid group (n = 102).Although there were more patients in the steroid group who received norepinephrine before brain death (80% vs. 66%: P = 0.03), mean dose of vasopressor administered after brain death was significantly lower than in the control group (1.18 ± 0.92 mg/H vs. 1.49 ± 1.29 mg/H: P = 0.03), duration of vasopressor support use was shorter (874 min vs. 1160 min: P 0.0001) and norepinephrine weaning before aortic clamping was more frequent (33.8% vs. 9.5%: P 0.0001). Using a survival approach, probability of norepinephrine weaning was significantly different between the two groups (P 0.0001) with a probability of weaning 4.67 times higher in the steroid group than in the control group (95% CI: 2.30 - 9.49).Despite no observed benefits of the steroid administration on primary function recovery of transplanted grafts, administration of glucocorticoids should be a part of the resuscitation management of deceased donors with hemodynamic instability. |
| اللغة: | English |
| تدمد: | 1466-609X 1364-8535 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b1ed6892bed257177ec01ba0a5e205f8Test http://europepmc.org/articles/PMC4331331Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b1ed6892bed257177ec01ba0a5e205f8 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1466609X 13648535 |
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