Nöroloji Yoğun Bakım Ünitesinde Beyin Ölümü Tanısı Konulan Olguların İncelenmesi

Authors : Türkay Akbaş, Zeynep Kurtpinar, Songül Şenadim, Eda Çoban, Vildan Özkubat, Sünkar Kaya Bayrak, Hatice Ateş Güllü, Belgin Mutluay, Aysun Soysal, Sevim Baybaş, Dilek Atakli

Pages : 309-313

View : 33 | Download : 10

Publication Date : 2018-09-01

Article Type : Research

Abstract :objectives: The main reason why we have insufficient organ donation from cadavers in our country is the lack of focus on brain death BD by the clinicians working in the intensive care unit ICU . The aim of this study was to analyze patients diagnosed with BD in a neurological ICU. Patients and Methods: We retrospectively analyzed twenty-three patients who had been diagnosed within the year by BD in the Neurological ICU of Bakirköy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery. Results: The mean age was 62+14 and 56.3% were male. The admission diagnoses were ischemic infarction 52.2% , intracerebral hemorrhage 39.2% , sinus thrombosis 4.3% and hypoxic encephalopathy 4.3% . The time interval between ICU admission and BD diagnosis was 27.5 hours. The signs leading to BD were brainstem areflexia, decreased Glasgow coma score, loss of spontaneous breath and polyuria which were noticed first by the neurologists in 10 subjects and by the intensive care specialists and anaesthesiologists in 13 subjects. BD decisions in 15 patients were given by apnea testing and neurologic examination. Further tests were conducted in five patients because of inability to perform apnea tests whereas neurologists ordered additional tests in three patients. The rates of hypotension, diabetes insipidus and hypothermia were 95.5%, 78% and 61.9%, respectively, and they were managed properly. Organ donation rate was 13%. conclusion: The doctors and nurses working in an ICU should be trained on how to recognize BD and to manage potential organ donors. This will improve BD diagnosis and increase organ donations
Keywords : Apnea testing, diabetes insipidus, donation, Glasgow coma score