Skip to main content

Cardiac output monitoring in brain-stem-dead potential organ donors: an audit of current UK practice

Introduction

Significant changes in haemodynamics occur after brain stem death (BSD) and there is evidence that yield of transplantable organs may be decreased in donors who remain preload responsive prior to donation [1], suggesting that optimisation of the cardiac output (CO) may be beneficial in potential organ donors. We describe current UK practice with regard to CO monitoring in this group.

Methods

We reviewed a database of 287 brain-stem-dead potential organ donors collected by specialist nurses in organ donation (SN-OD) over a 6-month period (30 April 2011 to 31 October 2011) across multiple UK centres. The database contained data on donor management in the period from initial SN-OD review to immediately prior to transfer to the operating theatre. We analysed data on CO monitoring and vasopressor/inotrope use. Where information was missing/not recorded in the dataset, the treatment referred to was interpreted as not given/not done.

Results

Fifty-three patients (18.5%) had evidence of CO monitoring. LiDCO was the most popular method (Figure 1). A total of 264 (94%) patients received treatment with vasopressors and/or inotropes. CO data were utilised in a variety of ways (Figure 2).

Figure 1
figure1

CO device.

Figure 2
figure2

Use of CO data.

Conclusion

The majority of potential donors require vasopressors and/or inotropes post BSD, but it seems only a minority currently have their CO monitored. There is variation in how CO data are utilised to direct haemodynamic management. We welcome the development of standardised bundle-driven donor management.

References

  1. 1.

    Murugan R, HIDonOR Study Investigators, et al.: Preload responsiveness is associated with increased interleukin-6 and lower organ yield from braindead donors. Crit Care Med 2009, 37: 2387-2393. 10.1097/CCM.0b013e3181a960d6

    PubMed Central  Article  CAS  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to CJ Wright.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Wright, C., Broderick, A. & Mandersloot, G. Cardiac output monitoring in brain-stem-dead potential organ donors: an audit of current UK practice. Crit Care 17, P177 (2013). https://doi.org/10.1186/cc12115

Download citation

Keywords

  • Public Health
  • Cardiac Output
  • Emergency Medicine
  • Operating Theatre
  • Transplantable Organ