Abstract
Amaç: Bu çalışmanın amacı, çocuk yoğun bakıma yattıktan sonra beyin ölümü tanısı alan hastaların sıklığını ve donasyon oranını tespit etmekti.
Gereç ve Yöntemler: Geriye dönük bir çalışma olarak yapıldı. Otuz iki yataklı Ankara Şehir Hastanesi Çocuk Yoğun Bakım Ünitesi’nde beyin ölümü tanısı konan hastalar hasta formuna kaydedildi. 01.12.2019 ile 01.12.2021 tarihleri arasında beyin ölümü tanısı almış hastalar dahil edildi.
Bulgular: Çocuk yoğun bakım ünitesinde (n= 325) ölen hastalar tarandı. Bu ölen hastalardan 17 (%5.2)’sında beyin Ölümü (BÖ) tanısı kondu. Beyin ölümüne neden olan altta yatan hastalıklar, 7 (%42) hastada santral sinir sistemi patolojileri (serebral palsi, meningosel,hidrosefali vb.) olan hastalardı, 5 (%29)’inde kafa travması (trafik kazaları ve düşme gibi nedenler), 5 (%29) hasta kardiyopulmoner arrest sonrası olmasıdır. Tüm hastalara ek test olarak Kranial BT anjiyo uygulandı. Hipernatremi olan 6 (%35) hasta Santral Diyabetus Insipitus (DI) tanısı aldı. BÖ tanısı konan hastalardan sadece biri (%6) donör olmayı kabul etti.
Sonuç: Beyin ölümü tanısı daha sık konulmalıdır. Organ bağışı için halk bilgilendirilmelidir. Organ nakli için kamuoyu oluşturulmalıdır.
Supporting Institution
yok
Project Number
-
References
- Wijdicks EF. Brain death worldwide: accepted fact but no global consensus in diagnostic criteria. Neurology 2002:58:20–5.
- Gündüz RC, Şahin Ş, Uysal-Yazici M, Ayar G, Yakut HI, Oden Akman A, et al. Brain death and organ donation of children. Turk J Pediatr 2014;56:597–603.
- Varelas PN, Rehman M, Abdelhak T, Patel A, Rai V, Barber A, et al. Single brain death examination is equivalent to dual brain death examinations. Neurocrit Care 2011:15:547–53.
- Wijdicks EFM. The diagnosis of brain death. N Engl J Med 2001;344:1215-21.
- Haupt WF, Rudolf J. European brain death codes: A comparison of national guidelines. J Neurol 1999;246:432-7.
- Wise-Faberowski L, Soriano SG, Ferrari L, McManus ML, Wolfsdorf JI, Majzoub J et al. Perioperative management of diabetes insipidus in children. J Neurosurg Anesteziol 2004 16:220–25.
- Mishra G, Chandrashekhar SR. Management of diabetes insipidus in children. Hint J Endokrinol Metab 2011;15 S180–7.
- Lago PM, Piva J, Garcia PC, Troster E, Bousso A, Sarno MO, et al. Brain death: medical management in seven Brazilian pediatric intensive care units. J Pediatr (Rio J) 2007;83:133–40.
- Joffe AR, Shemie SD, Farrell C, Hutchison J, McCarthy-Tamblyn L. Brain death in Canadian PICUs: demographics, timing, and irreversibility. Pediatr Crit Care Med 2013;14:1–9.
- Goh AY, Mok Q. Clinical course and determination of brainstem death in a children’s hospital. Acta Paediatr 2004;93:47–52.
- Machado C. Diagnosis of brain death. Neuro Int 2010;2:e2.
- Fackler JC, Troncoso JC, Gioia FR. Age-specific characteristics of brain death in children. Am J Dis Child 1988;142:999–1003.
- Staworn D, Lewison L, Marks J, Turner G, Levin D. Brain death in pediatric intensive care unit patients: incidence, primary diagnosis, and the clinical occurrence of Turner’s triad. Crit Care Med 1994;22:1301–5.
- Alharfi IM, Stewart TC, Foster J, Morrison GC, Fraser DD. Central diabetes insipidus in pediatric severe traumatic brain injury. Pediatr Crit Care Med 2013;14:203–9.
- Outwater KM, Rockoff MA. Diabetes insipidus accompanying brain death in children. Neurology 1984;34:1243–6.
- Finfer S, Bohn D, Colpitts D, Cox P, Fleming F, Barker G. Intensive care management of paediatric organ donors and its effect on post-transplant organ function. Intensive Care Med 1996;22:1424–32.
- Frampas E, Videcoq M, de Kerviler E. CT angiography for brain death diagnosis. AJNR 2009;30:1566–70.
- Nair-Collins M, Northrup J, Olcese J. Hypothalamic-Pituitary Function in Brain Death: A Review. J Intensive Care Med 2016;31:41–50.
Abstract
Objective: The aim of this study was to determine the frequency of patients diagnosed with brain death after admission to thepediatric intensive care unit and the organ donation rate.
Material and Methods: The study was carried out as a retrospective analysis. Patients diagnosed with brain death in the pediatric intensive care unit of the Ankara City Hospital were recorded in the patient form. The study was limited to patients admitted to the hospital between 1 December 2019 and 1 December 2021.
Results: The data of the patients who died in the PICU (n= 325) were evaluated. A total of 17 (5.2%) of these patients were diagnosed with brain death (BD). The underlying diseases of brain death in 7 (42%) patients was central nervous system disorders (cerebral palsy, meningocele, hydrocephalus, etc.), head trauma (such as traffic accidents and falls) in 5 others (29%), and hypoxic-ischemic injury owing to cardiopulmonary arrest in the remaining 5 (29%) patients. Cranial CT angiography was performed to all patients as an ancillary test. Six (35%) patients with hypernatremia were diagnosed with Central Diabetes Insipidus (DI). Only one patient became an organ donor.
Conclusion: The diagnosis of brain death should be made more frequently. People should be informed about organ donation, Many attempts should be made to influnce public opinion about the benefits of the organ transplantation.
Project Number
-
References
- Wijdicks EF. Brain death worldwide: accepted fact but no global consensus in diagnostic criteria. Neurology 2002:58:20–5.
- Gündüz RC, Şahin Ş, Uysal-Yazici M, Ayar G, Yakut HI, Oden Akman A, et al. Brain death and organ donation of children. Turk J Pediatr 2014;56:597–603.
- Varelas PN, Rehman M, Abdelhak T, Patel A, Rai V, Barber A, et al. Single brain death examination is equivalent to dual brain death examinations. Neurocrit Care 2011:15:547–53.
- Wijdicks EFM. The diagnosis of brain death. N Engl J Med 2001;344:1215-21.
- Haupt WF, Rudolf J. European brain death codes: A comparison of national guidelines. J Neurol 1999;246:432-7.
- Wise-Faberowski L, Soriano SG, Ferrari L, McManus ML, Wolfsdorf JI, Majzoub J et al. Perioperative management of diabetes insipidus in children. J Neurosurg Anesteziol 2004 16:220–25.
- Mishra G, Chandrashekhar SR. Management of diabetes insipidus in children. Hint J Endokrinol Metab 2011;15 S180–7.
- Lago PM, Piva J, Garcia PC, Troster E, Bousso A, Sarno MO, et al. Brain death: medical management in seven Brazilian pediatric intensive care units. J Pediatr (Rio J) 2007;83:133–40.
- Joffe AR, Shemie SD, Farrell C, Hutchison J, McCarthy-Tamblyn L. Brain death in Canadian PICUs: demographics, timing, and irreversibility. Pediatr Crit Care Med 2013;14:1–9.
- Goh AY, Mok Q. Clinical course and determination of brainstem death in a children’s hospital. Acta Paediatr 2004;93:47–52.
- Machado C. Diagnosis of brain death. Neuro Int 2010;2:e2.
- Fackler JC, Troncoso JC, Gioia FR. Age-specific characteristics of brain death in children. Am J Dis Child 1988;142:999–1003.
- Staworn D, Lewison L, Marks J, Turner G, Levin D. Brain death in pediatric intensive care unit patients: incidence, primary diagnosis, and the clinical occurrence of Turner’s triad. Crit Care Med 1994;22:1301–5.
- Alharfi IM, Stewart TC, Foster J, Morrison GC, Fraser DD. Central diabetes insipidus in pediatric severe traumatic brain injury. Pediatr Crit Care Med 2013;14:203–9.
- Outwater KM, Rockoff MA. Diabetes insipidus accompanying brain death in children. Neurology 1984;34:1243–6.
- Finfer S, Bohn D, Colpitts D, Cox P, Fleming F, Barker G. Intensive care management of paediatric organ donors and its effect on post-transplant organ function. Intensive Care Med 1996;22:1424–32.
- Frampas E, Videcoq M, de Kerviler E. CT angiography for brain death diagnosis. AJNR 2009;30:1566–70.
- Nair-Collins M, Northrup J, Olcese J. Hypothalamic-Pituitary Function in Brain Death: A Review. J Intensive Care Med 2016;31:41–50.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Project Number | - |
| Publication Date | March 16, 2022 |
| Submission Date | January 11, 2022 |
| Published in Issue | Year 2022 Volume: 16 Issue: 2 |
The publication language of Turkish Journal of Pediatric Disease is English.
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