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Systemic and regional hemodynamic and metabolic changes in an experimental model of brain death
Critical Carevolume 11, Article number: P15 (2007)
Despite the evolution of transplant techniques, the great number of donated organs continues to proceed from donors in brain death (BD). The need for stabilization in patients with BD, in the view of the triggered autonomic storm, is basic in such a way that knowledge of the physiopathologic, hemodynamic and metabolic disturbances becomes essential.
We evaluated hemodynamic and metabolic changes induced by experimental BD in dogs.
Materials and methods
Ten anesthetized and ventilated mongrel dogs (17–25 kg) were subjected to BD, by brainstem herniation, induced through an intracerebral balloon filled to maintain intracranial pressure (ICP) > systolic arterial pressure for 30 minutes (baseline – T30). The animals were observed for 30 minutes thereafter (T60). Systemic hemodynamics was evaluated by arterial and pulmonary artery catheters, while regional perfusion was assessed by portal vein blood flow (PVBF) and hepatic artery blood flow (HABF) with ultrasonic flow probes.
See Table 1. The data are expressed as the mean ± SEM.
BD promoted an initial hyperkinetic state followed by marked hypotension without systemic and regional lactic acidosis. In spite of the severe hypotension, the hepatosplachnic blood flow was preserved.