DOI: http://dx.doi.org/10.18203/2349-3933.ijam20202120

Key points of cooperation for successful implementation of bedside TCD in brain death determination

Guixing Xu, Dawei Liu, Fang Xiao, Donghua Zheng

Abstract


Background: To clarify the key points of cooperation in bedside TCD examination of potential brain death patients and ensure the successful implementation of bedside TCD.

Methods: From June 2018 to May 2019, the clinical data of potential brain death patients, admitted in ICU of the First Affiliated Hospital of Sun Yat-sen University, were prospectively collected; for patients undergoing bedside TCD examination, through cooperating with TCD examination doctors, the related key points were summarized and analyzed.

Results: Among 127 patients entered the study, including 103 males and 24 females, mean age is (33.2±15.2) years. 112 cases (88.2%) successfully implemented bedside TCD, 15 cases (11.8%) failed to implement bedside TCD. Univariate and multivariate analysis showed that: reasonable blood pressure regulation (systolic pressure: 90-140mmhg) (or = 6.58, 95% CI: 1.72-31.69), effective CCA compression test (rapid and accurate compression) (or = 13.62, 95% CI: 3.04-78.93) and body position adjustment (back and bed surface angle: 30-60°) (or = 11.76, 95% CI: 1 49-76.28) is the key points of cooperation for the successful implementation of bedside TCD in potential brain death patients.

Conclusions: The targeted cooperation can ensure the successful implementation of bedside TCD judgment of brain death, and the results need further external validation.


Keywords


Bedside, Brain death, Cooperation, Intensive care unit, Transcranial doppler

Full Text:

PDF

References


Brain Injury Evaluation Quality Control Centre of National Heath. Commission Criteria and practical guidance for determination of brain death in children. Chinese J Pediatr, 2019;57(5):331-5.

Brain Injury Evaluation Quality Control Centre of National Heath, Neurocritical Care Committee of Chinese Society of Neurology, Neurocritical Care Committee of Chinnese neurologist association. China Criteria and practical guidance for determination of brain death in adults. Chinese Med J. 2019;99(17):1288-92.

Martin-Loeches I, Sandiumenge A, Charpentier J, Kellum JA, Gaffney AM, Procaccio F, et al. Management of donation after brain death (DBD) in the ICU: the potential donor is identified, what's next?. Intensive Care Medicine. 2019 Mar 13;45(3):322-30.

Robba C, Cardim D, Sekhon M, Budohoski K, Czosnyka M. Transcranial Doppler: a stethoscope for the brain‐neurocritical care use. J Neurosc Rese. 2018 Apr;96(4):720-30.

Blanco P, Abdo-Cuza A. Transcranial Doppler ultrasound in neurocritical care. J Ultrasound. 2018, 21(1):1-16.

Hua Y, Gao S, Wu G, Pan X, Qian S. A guide for operation norm and diagnostic criteria of transcranial Doppler. Chinese J Med Ultrasound. 2008,5(2):197-222.

Huang J. To create organ donation and transplantation system that is in line with China's national conditions. Chinese J Surg. 2013 Jan;51(1).

Ding ZY, Zhang Q, Wu JW, Yang ZH, Zhao XQ. A comparison of brain death criteria between China and the United States. Chinese Medi J. 2015 Nov 5;128(21):2896.

Guixing XU, Zheng D, Liao Y, Guo Z, Xiaoshun HE. The 3-durgs-effect analysis of vasopressin, thyroxine and corticosteroids in 109 brain death donors. Chinese J Organ Transplant. 2018 Jan 1;39(6):364-8.

Yang S, Wang X, Chao WL. Analysis of the nursing adverse events based on 335 cases from the reporting system. 2010;45(2):130-2.

Zhu YC, Jin YM. The characteristics for unplanned extubation of inpatients and prevention strategies. Chinese J Nurs. 2009;44(3):256-8.

Chen AP, Cai M. Research advances of patient's unplanned extubation in ICU. Chinese J Nursing. 2007;42(10):934-7.

Ai ZP, Gao XL, Zhao XL. Factors associated with unplanned extubation in the Intensive Care Unit for adult patients: A systematic review and meta-analysis. Intensive Crit Care Nurs. 2018 Aug;47:62-8.