Cardiac Function in Brain Death, Usage of Advanced Hemodynamic Monitoring

Alireza Jahangirifard; Fateme Monjazebi; Alireza Ilbeigi; Nafiseh Naghdipour; Zargham Hossein  Ahmadi; Farahnaz Sadegh Beigee; Sanaz Dehghani

doi:10.18502/aacc.v8i1.8241

Alireza Jahangirifard Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Fateme Monjazebi Department of Medical-Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Alireza Ilbeigi Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nafiseh Naghdipour Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Zargham Hossein Ahmadi Lung Transplant Research Center, National Research Institute for Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Farahnaz Sadegh Beigee Lung Transplant Research Center, National Research Institute for Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sanaz Dehghani Organ procurement unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v8i1.8241

Keywords: Echocardiography; Advanced hemodynamic monitoring; Organ donation; Heart donation

Abstract

Background: This study used advanced hemodynamic monitoring along with simultaneous echocardiography to assess donated heart function of brain death patients using advanced hemodynamic monitoring and its efficacy in organ donation.

Methods: Forty-eight brain death patients who were candidates of heart donation on the basis of primary standard investigations were selected with purposive and convenient sampling methods. They were investigated with advanced hemodynamic monitoring after echocardiography and primary assessments and the gleaned data were recorded.

Results: Echocardiography showed that LVS (left ventricle size) and LVF (left ventricle function) were normal in %100 and %87.5 of patients, respectively. LVEF (left ventricle ejection fraction) was <%50 in %12.5 and >%50 in %87.5 of patients. SVR was smaller than 1200 at the beginning of the study that reached %54.4 at the end of the study. CI (cardiac index) was < 2.4 in %16.7 of the patients at the onset of the study that reached %25 at the end. Reduction of CI and SVR in patients with EF <%50 was significantly higher than that in patients with EF>%50.

Conclusion: Given the extensive pathological changes in the cardiovascular system exerted by brain death, advanced hemodynamic monitoring, if performed continually, can greatly aid in managing inotropic drugs in these patients, decision-making for managing intravascular volume, creating hemodynamic stability, and finally, preventing deterioration of function of the donated heart and loss of a donated organ.