Balance of fluids in potential multiple organ donors at a trauma referral center

Abstract

Introduction: The aggressive and effective approach to the potential donor benefits multiple organ transplantation both quantitatively and qualitatively. In view of the physiological changes in brain death, hemodynamic balance plays an important role in optimizing this group. Purpose: to assess the fluid balance and other parameters of hemodynamic profile of patients diagnosed with brain death in ICU related to clinical setting of multiple organ transplantation. Methods: descriptive, retrospective and cross-sectional study of patients diagnosed with brain death from 2013 to 2014 in an ICU trauma reference center in Pernambuco. Data were systematically extracted from patients' medical records, and the variables of general, clinical and fluid balance profile were synthesized by absolute and relative frequency. Results: Of 41 brain death diagnosis, 34 potential donors were analyzed, of which 15 (44%) performed organ donation. Head trauma, male gender and ages from 41 to 50 years old were predominant in the group. Kidneys and liver were the most donated organs, and there was no lung transplantation. All were using vasoactive drugs and the fluid balance was highly positive on the first and second days of the potential deceased donor s assessment. Conclusion: Despite hyper hydration, effective organ donation has been above average in this center. The permissiveness of high positive fluid balance is justified by the absence of lung transplantation center in the region. Strict control of the hemodynamic profile of the potential organ donor increases the feasibility of the transplant and must be adapted and systematized to the reality of each location.