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潜在脑死亡供者的血流动力学维持策略:综合评价。

Strategies for hemodynamic maintenance of potential brain-dead donor: integrative review.

机构信息

Universidade Estadual do Paraná, Paranavaí, PR, Brazil.

Universidade Federal de Mato Grosso do Sul, Coxim, MS, Brazil.

出版信息

Einstein (Sao Paulo). 2021 Jun 25;19:eRW5630. doi: 10.31744/einstein_journal/2021RW5630. eCollection 2021.

Abstract

OBJECTIVE

To learn about the scientific production on strategies adopted for hemodynamic maintenance of brain-dead patients.

METHODS

Integrative review with articles published between 2007 and 2019, in Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), PubMed® and ScienceDirect. The descriptors " Hemodinâmica AND Morte Encefálica " and "Hemodynamics AND Brain Death" were used. Exclusion criteria were non-human research and gray literature.

RESULTS

A total of 21 articles were listed. As strategies, the use of drugs - noradrenaline (n=8), vasopressin (n=7), dobutamine (n=6), hydrocortisone (n=4) and methylprednisolone (n=4); invasive (n=10) and noninvasive (n=13) cardiac monitoring; control of ventilatory parameters (n=12); and correction of fluid and electrolyte disturbances (n=17) were highlighted.

CONCLUSION

The main strategies found in this integrative review were regulation of blood pressure and temperature, use of catecholamines and corticosteroids, in addition to the need for an early diagnosis of brain death. However, the lack of clearer protocols on the subject is notorious, making management with the potential donor difficult.

摘要

目的

了解脑死亡患者血流动力学维持所采用策略的科学成果。

方法

综合复习 2007 年至 2019 年间在科学电子图书馆在线(SciELO)、拉丁美洲和加勒比健康科学文献(LILACS)、PubMed®和 ScienceDirect 上发表的文章。使用的主题词是“ Hemodinâmica AND Morte Encefálica”和“Hemodynamics AND Brain Death”。排除标准是非人类研究和灰色文献。

结果

共列出 21 篇文章。作为策略,使用药物-去甲肾上腺素(n=8)、血管加压素(n=7)、多巴酚丁胺(n=6)、氢化可的松(n=4)和甲基强的松龙(n=4);有创(n=10)和无创(n=13)心脏监测;呼吸参数控制(n=12);以及纠正液体和电解质紊乱(n=17)。

结论

在这项综合审查中发现的主要策略是调节血压和体温、使用儿茶酚胺和皮质类固醇,此外还需要早期诊断脑死亡。然而,该主题缺乏更清晰的方案是众所周知的,这使得潜在供体的管理变得困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7464/8225261/7c6a2375a6e1/2317-6385-eins-19-eRW5630-gf01.jpg

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