Effects of polyethylene glycol-20k IV solution on donor management in a canine model of donor brain death - 18/06/22
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Abstract |
Background |
Traditionally, vasopressors and crystalloids have been used to stabilize brain dead donors; however, the use of crystalloid is fraught with complications. This study aimed to investigate the effectiveness of a newly developed impermeant solution, polyethylene glycol-20k IV solution (PEG-20k) for resuscitation and support of brain dead organ donors.
Methods |
Brain death was induced in adult beagle dogs and a set volume of PEG-20k or crystalloid solution was given thereafter. The animals were then resuscitated over 16 h with vasopressors and crystalloid as necessary to maintain mean arterial pressure of 80–100 mmHg. The kidneys were procured and cold-stored for 24 h, after which they were analyzed using the isolated perfused kidney model.
Results |
The study group required significantly less crystalloid volume and vasopressors while having less urine output and requiring less potassium supplementation than the control group. Though the two groups’ mean arterial pressure and lactate levels were comparable, the study group’s kidneys showed less preservation injury after short-term reperfusion indexed by decreased lactate dehydrogenase release and higher creatinine clearance than the control group.
Conclusions |
The use of polyethylene glycol-20k IV solution for resuscitating brain dead donors decreases cell swelling and improves intravascular volume, thereby improving end organ oxygen delivery before procurement and so preventing ischemia-reperfusion injury after transplantation.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | PEG-20k reduce the amount of IV fluids required for organ recovery. |
• | Urine output was reduced with PEG-20k solution compared to standard of care. |
• | Epinephrine was reduced but not vasopressin with PEG-20k. |
• | Kidney had less preservation injury in PEG-20k donors.. |
Keywords : Impermeant, Polyethylene-glycol, Organ donation, Neurogenic shock
Plan
Vol 152
Article 113293- août 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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