COVID-19 pandemisinde beyin ölümü tanısı ve yönetimi

Year 2022, Volume: 47 Issue: 3, 942 - 949, 30.09.2022

Ayşe Neslihan Balkaya , Asiye Demirel , Hamide Ayben Korkmaz , Buket Özyaprak , Nermin Kılıçarslan , Canan Yılmaz

https://doi.org/10.17826/cumj.1036931

Cited By: 2

Abstract

Amaç: Bu çalışma, COVID-19 pandemisi sırasında bir araştırma hastanesinde tespit edilen beyin ölümü (BÖ) ve kadavra bağışı vakalarının tanı ve yönetimindeki deneyimlerin paylaşılmasını amaçlamıştır.
Gereç ve Yöntem: 15/03/2020-15/05/2021 tarihleri arasında yoğun bakım ünitelerimizde (YBÜ) tanı alan BÖ olguları geriye dönük olarak değerlendirildi. Hastaların demografik özellikleri, birincil tanıları, yoğun bakıma kabul süreleri ve hastanede kalış süreleri analiz edildi. Klinik şüphe, tanı, beyan ve bağış veya kardiyak arrest süreleri ve gerçekleştirilen klinik yargıyı desteklemek için ek testler de değerlendirildi.
Bulgular: Çalışmaya yaş ortalaması 59.9 yıl olan %56.8'i erkek, %43.2'si kadın 37 olgu dahil edildi. YBÜ yatışlarında en sık (%54.1) tanı intrakraniyal kanama idi. Apne testleri sadece 27 hastada (%73) yapılabildi. 27 (%73) olguda ek test olarak cerebral BT-anjiyografi kullanıldı. 10 hastadan (%27) organ bağışı için aile onayı alındı ve bunların %70'i (n= 7) donör oldu. YBÜ'e yatışıyla BÖ tanısı arasındaki süre 114±92.8 (11-360) saat, klinik şüphe ile tanı arasındaki süre 32±15,1 (4-78) saat, donör olmayanlarda tanı ile kardiyak arrest arasındaki süre 24±15.2 (5-72) saat, tanı ile bağış arasındaki süre 23±7.6 (15-35) saatti.
Sonuç: COVID-19 nedeniyle yoğun bakım ünitelerinde doluluk, donör olabilecek hastaların YBÜ’ne kabulünü azaltmış, hastanemizde BÖ tespit, aile onayı ve organ bağışı sayılarında azalma olmuştur.

Keywords

beyin ölümü,, COVID-19, Donör, Organ transplantasyonu

Brain death diagnosis and management in the COVID-19 pandemic

Abstract

Purpose: This present study aimed to share experiences in the diagnosis and management of brain death (BD) and cadaveric donation cases, detected in a research hospital during the COVID-19 pandemic.
Materials and Methods: BD cases diagnosed between 15/03/2020-15/05/2021 in our intensive care units (ICU) were retrospectively evaluated. Patients’ demographic characteristics, primary diagnoses, ICU admission time, and length of hospital stay were analyzed. Clinical suspicion, diagnosis, declaration, and donation or cardiac arrest times and supplementary tests to support the clinical judgment performed were also evaluated.
Results: 37 cases, were included in the study. Intracranial hemorrhage was the most common (54.1%) diagnosis in ICU admissions. Apnea tests could be performed only in 27 patients (73%). Cerebral CT-angiography was used as a supplementarytary test in 27 (73%) cases. Family consent for organ donation was obtained from 10 patients (27%), and 70% (n= 7) of them became donors. The time between ICU admission and BD diagnosis time was 114±92.8 (11-360) hours, the time between clinical suspicion and diagnosis was 32±15.1 (4-78) hours, the time between diagnosis and cardiac arrest of non-donors was 24±15.2 (5-72) hours, and the time between diagnosis and donation was 23±7.6 (15-35) hours.
Conclusion: Occupancy in ICUs due to COVID-19 has reduced the admission of patients who may be donors to ICUs, and there has been a decrease in the number of BD detection, family approval, and organ donation in our hospital.

Keywords

Brain death, COVID-19, Donor, Organ transplantation

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