The 3-durgs-effect analysis of vasopressin, thyroxine and corticosteroids in 109 brain death donors / 中华器官移植杂志

ABSTRACT

Objective The purpose of this study was to improve the success of organ donation and organ quality by analyzing the hemodynamic stability effect of 3-durgs therapy in brain death donor.Methods In this prospective observational study,we collected clinical data of brain death donors,who was admitted in the First Affiliated Hospital,Sun Yet-sen University from October 2015 to December 2016."3-durgs" emphasizes simultaneous use and includes vasopressin,thyroxine and corticosteroids.The assessment of hemodynamics is based on blood pressure,heart rate,blood oxygen,urine volume,and vasoactive drugs.According to the time of admission,included patients were divided into two groups3-durgs therapy group and conventional therapy group therapy group;the clinical data were compared between two groups to analyze the effect of 3-durgs on hemodynamic stability.Furthermore,we used univariate and multivariable logistic regression analyses to assess associations between 3-durgs therapy and these variables.Results A total of 109 patients were included in the study;following the time sequence,54 cases enter into the conventional therapy group received conventional therapy,32 cases achieved hemodynamic stability;55 cases in 3-durgs group received 3-durgs and conventional therapy,45 cases achieved hemodynamic stability,3-durgs group is better than the conventional group.In the matter of high-does usage,single vasoactive agent can maintain hemodynamic stability rate and norepinephrine usage,3-durgs group is better than the conventional group.The univariate and multivariable analysis showed that the abnormal suprasellar cistern,midline shift,low free T3,axillary temperature more than 36.5 ℃ and central diabetes insipidus are associated with 3-durgs-hormone therapy.Conclusion 3-durgs therapy can contribute to maintain hemodynamic stability in brain death donors and reduce the usage of vasoactive agents,can improve the success rate of donations and improve the quality of occupied organ;meanwhile,the screened validities can predict the effectiveness of 3-durgs therapy.