García BA, Miranda PY, Castillo VK

Language: Spanish
References: 10
Page: 61-67
PDF size: 226.49 Kb.

ABSTRACT

Introduction: brain death is an undesirable result in medicine field, but it has beneficial effects. Dead patients with this criterion are the most common source of organs, one of the most important clues of organ transplantation program.
Objective: to characterize brain death from the clinical and radiological point of view in the Intensive Care Units of "Abel Santamaria Cuadrado" general-teaching hospital (January 2014-December 2015).
Method: a descriptive, prospective and cross-sectional study was conducted at "Abel Santamaria Cuadrado" general teaching hospital with patients admitted to the Intensive Care Units having the diagnosis of brain death (January 2014-December 2015). Data were collected from the clinical records. The target group comprised 175 deceased patients having central nervous system damage, the sample included 36 patients.
Results: the age bracket of 39-59 (41.67%), male gender (66.67%), and Caucasian race (61.11%) predominated. Hemorrhagic stroke (77.78%) was the most frequent cause of brain death, subarachnoid hemorrhage (39.29%). Effacement of the base cisternae (100%), and brain edema (100%) were the secondary lesions with the highest tomography registrations; 61% developed brain death in the first 24 hours, isolated systolic spike was the most reported echographic pattern through transcranial Doppler.
Conclusions: knowledge of how the elements characterizing brain death behave is vital for the early identification of potential donors, providing good quality organs for the transplantation programs.

REFERENCES

1. Escudero D, Matesanz R, Soratti CA, Flores JI, Consejo Iberoamericano de Donación y Trasplante. Consideraciones generales sobre la muerte encefálica y recomendaciones sobre las decisiones clínicas tras su diagnóstico. Med Intensiva [Internet]. 2009 [citado 10 Nov 2015]; 33(9): 45054. Disponible en: http://scielo.isciii.es/scielo.php?pid=S0210 -56912009000900007&script=sci_arttext

2. Machado C, Comisión Nacional para la Determinación y Certificación de la Muerte. Resolución para la determinación y certificación de la muerte en Cuba. Rev Neurol [Internet]. 2003 [citado 10 Nov 2015]; 36(8): 763-70. Disponible en: http://dialnet.unirioja.es/servlet/articulo?codigo=497290

3. Estado actual de donación y trasplantes en México, reporte anual. México: Centro Nacional de Transplante; 2013.

4. De la Rosa G, Domínguez Gil B, Matesanz R, Ramón S, Alonso Álvarez J, Araiz J et al. Continuously evaluating performance in deceased donation: The Spanish Quality Assurance. Program Am J Transplant [Internet]. 2012 [citado 10 Nov 2015]; 12(9): 2507-13. Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2012.04138.x/full

5. Bodí MA, Pont T, Sandiumenge A, Oliver E, Gener J, Badía M, et al. Potencialidad de donación de órganos en muerte encefálica y limitación del tratamiento de soporte vital en los pacientes neurocríticos. Med Intensiva [Internet]. 2015 [citado 10 Nov 2015]; 39(6): 337-44. Disponible en: http://www.medintensiva.org/es/potencialidad-donacion-organos-muerte-encefalica /articulo/S0210569114002095

6. Escudero D, Valentín MO, Escalante JL, Sanmartín A, Perez Basterrechea M, de Gea J, et al. Intensive care practices in brain death diagnosis and organ donation. Anaesthesia [Internet]. 2015 [citado 10 Nov 2015]; 70:11309. Disponible en: http://onlinelibrary.wiley.com/doi/10.1111 /anae.13065/full

7. Morales Ballesteros O, Pacheco Hoyos N, Antillón Valenzuela JE. Diagnóstico de muerte encefálica, en pacientes con clínica compatible, mediante resonancia magnética cerebral. Anales de Radiología México [Internet]. 2015 [citado 10 Nov 2015]; 14(3):273-84. Disponible en: http://www.medigraphic.com/pdfs/anaradmex/arm-2015/arm153e.pdf

8. Kompanje EJ, de Groot YJ, Bakker J. Is organ donation from brain dead donors reaching an inescapable and desirable nadir?. Transplantation [Internet]. 2011 [citado 10 Nov 2015]; 91(11):1177-80. Disponible en: http://journals.lww.com/transplantjournal/Abstract/2011/06150 /Is_Organ_Donation_From_Brain_Dead_Donors_Reaching.2.aspx

9. Escudero D, Otero J. Medicina intensiva y donación de órganos. ¿Explorando las últimas fronteras?. Med Intensiva [Internet]. 2015 [citado 10 Nov 2015]; 39(6): 366-74. Disponible en: http://www.medintensiva.org/es/medicina-intensiva-donacion-organos-explorando/articulo /S0210569115000431

10. Kostin A. Doppler transcraneal en Cuidados Intensivos Neurológicos. Revista Mexicana de Anestesiología [Internet]. 2015 Oct-Dic [citado 10 Nov 2015]; 38(Supl-3): S427-9. Disponible en: http://www.medigraphic.com/pdfs/rma/cma-2015/cmas153f.pdf