Aldo García-Covarrubias, Luis García-Covarrubias, Dulce A Alcántara-López, Héctor Hinojosa-Heredia, Paola Prieto-Olivares, Arturo Reding-Bernal
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引用次数: 1
Abstract
Antecedents: In the field of organ donation and procurement, a possible donor is a patient with severe neurological damage and appropriate medical criteria for donation, and a potential donor is a patient suspected of being brain dead.
Objective: The aim of this study is to identify specific factors that cause the loss of possible multiorgan donors in an intensive care unit (ICU).
Methods: A review of cross-sectional charts of possible liver and kidney donors was done with patients admitted to the ICU with full respiratory support and Glasgow score < 8. A multiple logistical regression model was applied to identify the loss of potential donors previously considered only as possible donors.
Results: A total of 44 charts were reviewed, 26 were possible, and 18 were potential donors. The mean average was 46.7 and 52.8 years for possible and potential donors, respectively (p = 0.272). The potential donors experienced frequent intracranial hemorrhage (19.2 vs. 55.6) or renal injury (3.9 vs. 27.8), and fewer invasive procedures are performed (34.6 vs. 5.6) (p <0.05). Invasive procedure resulted significant (p = 0.013) when a multivariate analysis was done.
Discussion and conclusions: Patients submitted to invasive procedures have 20 times more probabilities of being lost as kidney donors even when originally considered as possible donors. Medical or surgery procedures are the leading cause for the loss of potential donors, so an opportune detection is essential.
前情:在器官捐赠和获取领域,可能的捐赠者是患有严重神经损伤且符合捐赠医学标准的患者,潜在的捐赠者是疑似脑死亡的患者。目的:本研究的目的是确定导致重症监护病房(ICU)可能的多器官供体丢失的具体因素。方法:回顾可能的肝脏和肾脏供体的横断面图表,并对ICU住院的完全呼吸支持和格拉斯哥评分< 8的患者进行分析。一个多重逻辑回归模型被应用于确定潜在捐赠者的损失,以前只被认为是可能的捐赠者。结果:共审查了44张图表,26张是可能的,18张是潜在的捐赠者。可能和潜在捐献者的平均年龄分别为46.7岁和52.8岁(p = 0.272)。潜在的供体经常出现颅内出血(19.2 vs. 55.6)或肾损伤(3.9 vs. 27.8),进行侵入性手术的患者较少(34.6 vs. 5.6) (p讨论和结论:接受侵入性手术的患者失去肾供体的可能性是其20倍,即使最初被视为可能的供体。医学或外科手术是失去潜在捐赠者的主要原因,因此及时发现是至关重要的。
期刊介绍:
Cirugía y Cirujanoses exponente del desarrollo académico, científico, médico, quirúrgico y tecnológico en materia de salud en México y en el ámbito internacional. Es una revista bimestral, open access, revisada por pares, que publica en español y en inglés (traducido sin coste para los autores) artículos científicos originales, casos clínicos, artículos de revisión de interés general y cartas al editor. Los artículos se seleccionan y publican siguiendo un riguroso análisis, de acuerdo con los estándares internacionalmente aceptados. Sus espacios están abiertos a los académicos, así como a todo miembro de la comunidad médica que manifieste interés por utilizar este foro para publicar sus trabajos.