Mutlu Nevzat Mehmet, Peker Tülay Tunçer, Acar Sevim, Koca Betül, Soyal Özlem Balkız, Titiz Ayşe Pınar, Çakır Esra, Göğüş Nermin
Department of Anesthesiology and Reanimation-Critical Care, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Department of Anesthesiology and Reanimation-Critical Care, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Transplant Proc. 2019 Sep;51(7):2176-2179. doi: 10.1016/j.transproceed.2019.01.164. Epub 2019 Jul 31.
We aimed to define the causes of brain death (BD), criteria, and tests used for diagnosis, rates of family consent, and rates of organ donation in intensive care units (ICUs) of an education and research hospital.
The data of patients with BD diagnosis in 7 years in our hospital was collected from an electronic database and archives retrospectively consisting of the demographic data, the causes of BD, criteria, and the tests used for diagnosis, family consent, and organ donation rates.
A total of 210 patients with BD diagnosis were enrolled in the study. There was a decline in number of patients with BD diagnosis between 2012 (54.76%) and 2018 (17.64%) in the neurology and neurosurgery ICU, while it increased from 35.71% in 2012 to 70.6% in 2018 in the general ICU. The most common cause of hospitalization for BD was spontaneous intracranial hemorrhage (43.8%). A total of 47.6% of brain-dead patients who did not qualify for organ donation were resuscitated unnecessarily after cardiac death. In 2012, diagnosis was always supported by ancillary tests, while in 2018, a total of 35.29% of the patients were diagnosed solely by clinical examination; 23.8% of patients' families had given consent for organ donation, and 19.53% of 210 patients became donors.
Physicians should be aware that patients with poor neurologic outcome can be candidates of BD donation, and careful examination and rapid diagnosis is crucial. All segments of society and the health care professionals should be informed and updated about organ donation and BD regularly to raise the numbers of organ donation.
我们旨在明确一家教学和研究医院重症监护病房（ICU）中脑死亡（BD）的病因、诊断标准及检测方法、家属同意率和器官捐献率。
回顾性收集我院7年间BD诊断患者的数据，这些数据来自电子数据库和档案，包括人口统计学数据、BD病因、诊断标准及检测方法、家属同意情况和器官捐献率。
本研究共纳入210例BD诊断患者。神经科和神经外科ICU中BD诊断患者数量在2012年（54.76%）至2018年（17.64%）呈下降趋势，而综合ICU中该比例从2012年的35.71%增至2018年的70.6%。BD住院的最常见病因是自发性颅内出血（43.8%）。共有47.6%不符合器官捐献条件的脑死亡患者在心脏死亡后被不必要地复苏。2012年，诊断总是得到辅助检测的支持，而2018年，共有35.29%的患者仅通过临床检查确诊；23.8%的患者家属同意器官捐献，210例患者中有19.53%成为捐献者。
医生应意识到神经功能预后差的患者可能是BD捐献的候选者，仔细检查和快速诊断至关重要。应定期向社会各阶层和医护人员宣传并更新器官捐献和BD的相关信息，以提高器官捐献数量。
