Park Eun Sun, Son Hee Won, Lee A-Ran, Lee Sang Hyun, Kim An Suk, Park Soon Eun, Cho Young Woo
Department of Anesthesiology and Pain Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Korean J Anesthesiol. 2014 Aug;67(2):133-8. doi: 10.4097/kjae.2014.67.2.133. Epub 2014 Aug 26.
Neurogenic pulmonary edema (NPE) in brain dead organ donors occurring after an acute central nervous system insult threatens organ preservation of potential organ donors and the outcome of organ donation. Hence the active and immediate management of NPE is critical. In this case, a 50-year-old male was admitted to the intensive care unit (ICU) for organ donation. He was hypoxic due to NPE induced by spontaneous intracerebral hemorrhage and intraventricular hemorrhage. Protective ventilatory management, intermittent recruitment maneuvers, and supportive treatment were maintained in the ICU and the operating room (OR). Despite this management, the hypoxemia worsened after the OR admission. So inhaled nitric oxide (NO) therapy was performed during the operation, and the hypoxic phenomena showed remarkable improvement. The organ retrieval was successfully completed. Therefore, NO inhalation can be helpful in the improvement of hypoxemia caused by NPE in brain dead organ donors during anesthesia for the organ donation.
急性中枢神经系统损伤后发生的脑死亡器官捐献者的神经源性肺水肿（NPE），威胁到潜在器官捐献者的器官保存及器官捐献的结果。因此，积极、及时地处理NPE至关重要。在此病例中，一名50岁男性因器官捐献入住重症监护病房（ICU）。他因自发性脑出血和脑室内出血诱发的NPE而出现低氧血症。在ICU和手术室（OR）维持保护性通气管理、间歇性肺复张手法及支持治疗。尽管采取了这些措施，但进入手术室后低氧血症仍恶化。因此，术中进行了吸入一氧化氮（NO）治疗，低氧现象显著改善。器官获取成功完成。所以，在器官捐献麻醉期间，吸入NO有助于改善脑死亡器官捐献者中由NPE引起的低氧血症。
