Introduction: Cardiac arrest (CA) is a catastrophic event with a high rate of mortality, often resulting in devastating brain injury that might evolve to brain death (BD)[1]. Organ donation from BD after CA patients with ECMO support is still a poorly explored field[2]. Methods: We retrospectively enrolled all patients admitted to our hospital between January 2011 and September 2016 after refractory CA treated with eCPR. Results: In the study period 112/215 CA patients received eCPR (52.09%). 30 eCPR-subjects (26.78%) survived at 6 months (85.71% with good cerebral performance, CPC 1-2). 82 died in ICU (25 BD, 22.32% and 57 for other causes, 50.89%)[Fig.1]. Deads vs. alives differed in age (p=0.02), comorbidities (p=0.001), CA (intra or extrahospital p=0.03), low flow time (p<0.0001), mean arterial pressure (p=0.004), glycemia (p=0.04) anemia (p=0.02), renal function (creatinine p<0.0001, urea p=0.0005), and early neurological evaluation (CT scan p<0.001, EEG recording p<0.001, brainstem reflexes p<0.001, presence of somatosensory potentials p=0.03 and GCS p<0.0001). BD and dead from other causes patients differed in early neurological evaluation (CT scan p<0.0001, EEG p=0.004, brainstem reflexes p=0.02), thrombocytopenia (p=0.008), coagulation derangement (p=0.01), inotropic support (p=0.03). Tab1 shows characteristics of eligible patients at the time of donation. Rate of donation in BD patients was 56% (refusal based on organ biopsy or evaluation in the operation room) with 39 donated organs (23 kidneys, 12 livers, 4 lungs, 89.74% with good functional recovery). Conclusions: eCPR patients might become BD and be considered potential resource for organ donation with a similar success rate as organs retrieved from patients deceased from other causes

Casadio, M., Coppo, A., Vargiolu, A., Villa, J., Rota, M., Avalli, L., et al. (2017). Organ donation after brain death in refractory cardiac arrest treated with extracorporeal CPR. CRITICAL CARE, 21(Suppl 1).

Organ donation after brain death in refractory cardiac arrest treated with extracorporeal CPR

CASADIO, MARIA CHIARA
Primo
;
COPPO, ANNA
Secondo
;
VARGIOLU, ALESSIA;ROTA, MATTEO;CITERIO, GIUSEPPE
Ultimo
2017

Abstract

Introduction: Cardiac arrest (CA) is a catastrophic event with a high rate of mortality, often resulting in devastating brain injury that might evolve to brain death (BD)[1]. Organ donation from BD after CA patients with ECMO support is still a poorly explored field[2]. Methods: We retrospectively enrolled all patients admitted to our hospital between January 2011 and September 2016 after refractory CA treated with eCPR. Results: In the study period 112/215 CA patients received eCPR (52.09%). 30 eCPR-subjects (26.78%) survived at 6 months (85.71% with good cerebral performance, CPC 1-2). 82 died in ICU (25 BD, 22.32% and 57 for other causes, 50.89%)[Fig.1]. Deads vs. alives differed in age (p=0.02), comorbidities (p=0.001), CA (intra or extrahospital p=0.03), low flow time (p<0.0001), mean arterial pressure (p=0.004), glycemia (p=0.04) anemia (p=0.02), renal function (creatinine p<0.0001, urea p=0.0005), and early neurological evaluation (CT scan p<0.001, EEG recording p<0.001, brainstem reflexes p<0.001, presence of somatosensory potentials p=0.03 and GCS p<0.0001). BD and dead from other causes patients differed in early neurological evaluation (CT scan p<0.0001, EEG p=0.004, brainstem reflexes p=0.02), thrombocytopenia (p=0.008), coagulation derangement (p=0.01), inotropic support (p=0.03). Tab1 shows characteristics of eligible patients at the time of donation. Rate of donation in BD patients was 56% (refusal based on organ biopsy or evaluation in the operation room) with 39 donated organs (23 kidneys, 12 livers, 4 lungs, 89.74% with good functional recovery). Conclusions: eCPR patients might become BD and be considered potential resource for organ donation with a similar success rate as organs retrieved from patients deceased from other causes
Abstract in rivista
Scientifica
cardiac arrest; extracorporeal CPR; brain death; organ donation
English
Poster n° P201 presented at the 37th International Symposium on Intensive Care and Emergency Medicine (ISICEM). Brussels (Belgium), 21-24 March 2017.
Casadio, M., Coppo, A., Vargiolu, A., Villa, J., Rota, M., Avalli, L., et al. (2017). Organ donation after brain death in refractory cardiac arrest treated with extracorporeal CPR. CRITICAL CARE, 21(Suppl 1).
Casadio, M; Coppo, A; Vargiolu, A; Villa, J; Rota, M; Avalli, L; Citerio, G
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/148968
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