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Korean J Crit Care Med > Volume 27(4); 2012 > Article
Korean Journal of Critical Care Medicine 2012;27(4): 286-289. doi: https://doi.org/10.4266/kjccm.2012.27.4.286
지속적 신대체 요법을 이용한 성공적인 뇌사 장기 공여자의 관리
임상현ㆍ이영주*ㆍ조한범*ㆍ이재명*ㆍ이인경*
아주대학교 의과대학 흉부외과학교실, *마취통증의학교실
Successful Brain Dead Donor Management with CRRT: A Case Report
Sang Hyun Lim, Young Joo Lee, Han Bum Joe, Jae Moung Lee, In Kyung Lee
1Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Korea.
2Department of Anesthesiology, Ajou University School of Medicine, Suwon, Korea. sicuab@hotmail.com
ABSTRACT
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.
Key Words: brain-dead donor; continuous renal replacement therapy; potential organ donor
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