Abstract
ABSTRACTObjective To learn about the scientific production on strategies adopted for hemodynamic maintenance of brain-dead patients.Methods Integrative review with articles published between 2007 and 2019, in Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), PubMed® and ScienceDirect. The descriptors “ Hemodinâmica AND Morte Encefálica ” and “Hemodynamics AND Brain Death” were used. Exclusion criteria were non-human research and gray literature.Results A total of 21 articles were listed. As strategies, the use of drugs – noradrenaline (n=8), vasopressin (n=7), dobutamine (n=6), hydrocortisone (n=4) and methylprednisolone (n=4); invasive (n=10) and noninvasive (n=13) cardiac monitoring; control of ventilatory parameters (n=12); and correction of fluid and electrolyte disturbances (n=17) were highlighted.Conclusion The main strategies found in this integrative review were regulation of blood pressure and temperature, use of catecholamines and corticosteroids, in addition to the need for an early diagnosis of brain death. However, the lack of clearer protocols on the subject is notorious, making management with the potential donor difficult.
Highlights
Organ transplantation is the most effective therapeutic alternative for many patients with end-stage diseases, and the waiting list for transplants has increased year after year
The search was conducted from November 2018 to February 2019, driven by the question: What are the strategies often adopted for hemodynamic maintenance in brain death (BD) patients? The electronic databases chosen for searching articles were the Latin American and Caribbean Health Sciences Literature (LILACS), PubMed®, Scientific Electronic Library Online (SciELO), and ScienceDirect
The use of drugs as a strategy for hemodynamic maintenance was described in 71.4% (n=15) of articles selected for the integrative review
Summary
Organ transplantation is the most effective therapeutic alternative for many patients with end-stage diseases, and the waiting list for transplants has increased year after year. Health education is reinforced as a relevant aspect for the dissemination of information on organ donation and brain death (BD), which highlights the importance of the participation of the multidisciplinary health team.(2) But the lack of more comprehensive evidence on the subject denotes the need for clearer guidelines to provide uniform management of individuals requiring this care. Brazil ranks second in number of transplants, behind the United States.(4) There was an increase of only 2.4% in effective donors in 2018, from 16.6 per million population (pmp), in 2017, to 17.0 pmp, in 2018. This rise was due to higher notification rate of potential donors by 2.2% of the donation attainment rate. In 2019, the number of effective donors was 18.1 pmp, with 40% of family refusal.(4)
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