Impact of Recruitment Maneuvers to Cover Adverse Effects of Donor Transfer.

Abstract

OBJECTIVES:

Our aim was to investigate the negative effects of transferring brain-dead donors to the intensive care unit on the ratio of PaO₂ to inspired oxygen fraction and the benefits of recruitment maneuvers on its reversal.

MATERIALS AND METHODS:

In this randomized trial, we assigned 30 brain-dead donors to an intervention group and a control group. After transfer to the intensive care unit, donors in the intervention group received a lung recruitment maneuver according to protocol for 1 hour, whereas the control group did not receive this intervention. Arterial blood gas was drawn before transfer, immediately aftertransfer, and 3 hours after transfer.

RESULTS:

Before transfer to immediately after transfer, the PaO₂-to-inspired oxygen fraction ratio decreased from 281.30 ± 100.33 to 225.03 ± 95.72 mm Hg (P < .01). At 3 hours aftertransfer,the PaO₂-to-inspired oxygen fraction ratio in the intervention and control groups was 280.4 ± 120.4 and 213.4 ± 75.5 mm Hg (P = .017), respectively. The absolute difference in PaO₂-to-inspired oxygen fraction ratio from before to 3 hours after transfer was -16.9 ± 44.1 and 51.8 ± 61.4 mm Hg (P < .001), in the intervention and control groups,respectively. Increasing central venous pressure and/or transfer time further potentiated the decrease ofthe PaO₂-to-inspired oxygen fraction ratio.

CONCLUSIONS:

The PaO₂-to-inspired oxygen fraction ratio decreased after transfer of brain-dead donors to the intensive care unit. This was partially reversible by standardized recruitment maneuvers.

• Authors: Fariba Ghorbani, Katayoun Najafizadeh, Carl-Ludwig Fischer-Fröhlich, Meysam Mojtabaee
• Journal: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation (Exp Clin Transplant) Vol. 18 Issue 4 Pg. 429-435 (08 2020) ISSN: 2146-8427 [Electronic] Turkey
• PMID: 31801446 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Blood Gas Analysis
• Brain Death (diagnosis, physiopathology)
• Female
• Humans
• Intensive Care Units
• Iran
• Lung (physiopathology, surgery)
• Lung Transplantation (adverse effects)
• Male
• Middle Aged
• Patient Transfer
• Respiration, Artificial (adverse effects)
• Time Factors
• Tissue Donors
• Treatment Outcome
• Young Adult