Prevalence of hemodynamic, acid and base, coagulation, electrolytes, and blood glucose disturbances and requiring inotropic support in patients with brain death on arrival at hospital intensive care unit

Abstract

Background: Brain death, as the loss of all brain functions including functions of the brain stem, is defined as a considerable part of mortality. Care of the patients with brain death is important as these patients are important sources for transplantation. Due to changes made in the brain and other organs, electrolyte, hemodynamic and hemostatic abnormalities have a high prevalence in patients with brain death. The recognition of these disorders is very important to have a correct view about the importance of prevention and management. The aim of this study was assessment of the prevalence of hemodynamic, acid and base, coagulation, electrolytes, and blood glucose abnormalities in patients with brain death on arrival at hospital intensive care unit (ICU). Methods: In a cross-sectional study during 2013-2014, the medical records of 119 patients with brain death who were hospitalized in ICUs of Alzahra Hospital, Isfahan, Iran, during 2010-2013 were studied. Hemodynamic, coagulation, electrolytes and glucose abnormalities, and the need for inotropic support for each patient were recorded on the data collection form. The frequency of organ donation in patients was assigned and the obtained data were analyzed using SPSS software. Findings: In 92 patients (77.3) organ donation was done. Impairment of pH (70.6), prothrombin time (PT) (66.4) and international normalized ratio (INR) (58.0) were the most common disorders seen in the patients. Impaired glucose and sodium levels were statistically significant in organ donation and not-donation groups. Conclusion: Patients with brain death, due to disturbances in hemodynamic, hemostatic, and coagulation time, lose the ability of organ donation. So, the decision to do organ donation should be made in the shortest possible time. © 2015, Isfahan University of Medical Sciences(IUMS). All rights reserved.