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Successful Brain Dead Donor Management with CRRT: A Case Report

机译：利用CRRT成功进行脑死亡捐献者管理：一例报告

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Brain death results in adverse pathophysiologic effects in many brain-dead donors with cardiovascular instability. We experienced a brain-dead donor with continuous renal replacement therapy (CRRT) who was in a severe metabolic, electrolyte derangement and poor pulmonary function. The thirty-nine-year-old male patient with subarachnoid hemorrhage and intraventricular hemorrhage was admitted into the intensive care unit (ICU). After sudden cardiac arrest, he went into a coma state and was referred to as a potential organ donor. When he was transferred, his vital sign was unstable even under the high dose of inotropics and vasopressors. Even with aggressive treatment, the level of blood sugar was 454 mg/dl, serum K+ 7.1 mEq/L, lactate 5.33 mmol/L and PaO2/FiO2 60.3. We decided to start CRRT with the mode of continuous venovenous hemodiafiltration (CVVHDF). After 12 hours of CRRT, vital sign was maintained well without vasopressors, and blood sugar, serum potassium and lactate levels returned to 195 of PaO2/FiO2. Therefore, he was able to donate his two kidneys and his liver.
机译：脑死亡导致许多脑死亡的心血管不稳定供体产生不利的病理生理影响。我们经历了一个连续性肾脏替代疗法（CRRT）的脑死亡供者，他的代谢严重，电解质紊乱且肺功能不佳。一名患有蛛网膜下腔出血和脑室内出血的三十九岁男性患者被送入重症监护病房（ICU）。心脏骤停后，他进入昏迷状态，被称为潜在的器官捐献者。转移后，即使在高剂量的正性肌力药和升压药的作用下，他的生命体征也不稳定。即使采取积极治疗，血糖水平仍为454 mg / dl，血清K + 7.1 mEq / L，乳酸5.33 mmol / L和PaO2 / FiO2 60.3。我们决定以连续静脉血液透析滤过（CVVHDF）模式开始CRRT。 CRRT 12小时后，没有血管加压药，生命体征保持良好，血糖，血清钾和乳酸水平恢复到195 PaO2 / FiO2。因此，他能够捐赠他的两个肾脏和肝脏。

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