在心脏检索过程中使用胸腔腹腔正常热区域输液进行神经监测:前性队列研究
Ana Tur1, Elaine Lo2, Iván Martín-González3
1Department of Anesthesiology and Surgical-Trauma Intensive Care, Hospital Politècnic i Universitari La Fe, Valencia, Spain.
概括
胸腔腹部正常热区域输液 (TA-NRP) 并没有恢复心脏捐赠者的脑血流或功能. 神经监测证实了大脑活动的停止和输液后的流动开始.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 器官移植 器官移植
背景情况:
- 常温区域输液 (NRP) 在器官捐献协议中使用.
- 在器官采集期间评估保留的大脑功能对于捐赠者管理和道德考虑至关重要.
研究的目的:
- 为了评估经过胸腔腹腔正常热区域输液 (TA-NRP) 的心脏捐献者的大脑功能和血液流动.
- 为了确定TA-NRP是否在停止维持生命治疗后恢复神经活动或大脑循环.
主要方法:
- 一项前性神经监测试验,涉及43名接受TA-NRP的心脏捐赠者.
- 在TA-NRP启动前后使用双光谱指数 (BIS),定量瞳孔测量和跨骨多普勒测量 (TCD).
- 在输液后的特定时间间隔监测大脑活动和流量.
主要成果:
- 所有捐赠者在TA-NRP启动后都表现出缺席的瞳孔光反射 (NPI=0).
- 经骨多普勒检测证实,TA-NRP后,在任何血管中都没有大脑血流.
- 中位数BIS值下降到0后TA-NRP,表明大脑功能损失.
结论:
- 在心脏捐赠者中,TA-NRP似乎无法恢复大脑血液流动或神经功能.
- 这些发现表明TA-NRP对捐赠者的潜在神经恢复是安全的.
- 建议进一步进行多中心验证,以确认这些神经监测结果.
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