TY - JOUR
T1 - The use of stroke volume variation to guide donor management is associated with increased organs transplanted per donor
AU - Bergstrom, Benjamin
AU - De La Cruz, J. Salvador
AU - Sally, Mitchell
AU - Louis, Scott
AU - Friedman, Melissa
AU - Petersen, Floyd
AU - Malinoski, Darren
N1 - Publisher Copyright:
© 2017, NATCO.
PY - 2017/6
Y1 - 2017/6
N2 - Background: There is a national shortage of organs available for transplantation, and utilization rates for thoracic organs are less than 40%. In addition, the optimal method of assessing cardiovascular status during donor management is uncertain. FloTrac is a noninvasive hemodynamic technique that measures cardiac output and fluid responsiveness. Our objective was to measure the impact of using this technique to guide management on fluid balance, vasopressor usage, thyroid hormone usage, and pulmonary function. We hypothesized that FloTrac guidance will increase thoracic organs transplanted per donor (OTPD). Methods: Data were prospectively collected on a convenience sample of 38 donors after neurologic determination of death. Organs transplanted, net fluid balance, dosage of vasopressors, dosage of thyroid hormone, and PaO2:FIO2 were compared between treatment and control groups. Results: The treatment group had greater thoracic OTPD (1.3 [1.0] vs 0.4 [0.6], P = .004) and overall OTPD (4.3 [1.5] vs 2.7 [1.5], P = .002). Donors in the treatment group maintained a neutral fluid balance, had more thyroid hormone used, and had an improvement in oxygenation. Conclusion: The implementation of this technology to aid providers may help ameliorate the shortage of thoracic and overall organs available for transplantation.
AB - Background: There is a national shortage of organs available for transplantation, and utilization rates for thoracic organs are less than 40%. In addition, the optimal method of assessing cardiovascular status during donor management is uncertain. FloTrac is a noninvasive hemodynamic technique that measures cardiac output and fluid responsiveness. Our objective was to measure the impact of using this technique to guide management on fluid balance, vasopressor usage, thyroid hormone usage, and pulmonary function. We hypothesized that FloTrac guidance will increase thoracic organs transplanted per donor (OTPD). Methods: Data were prospectively collected on a convenience sample of 38 donors after neurologic determination of death. Organs transplanted, net fluid balance, dosage of vasopressors, dosage of thyroid hormone, and PaO2:FIO2 were compared between treatment and control groups. Results: The treatment group had greater thoracic OTPD (1.3 [1.0] vs 0.4 [0.6], P = .004) and overall OTPD (4.3 [1.5] vs 2.7 [1.5], P = .002). Donors in the treatment group maintained a neutral fluid balance, had more thyroid hormone used, and had an improvement in oxygenation. Conclusion: The implementation of this technology to aid providers may help ameliorate the shortage of thoracic and overall organs available for transplantation.
KW - Donor management
KW - Stroke volume variation
KW - Transplantation
UR - http://www.scopus.com/inward/record.url?scp=85020673974&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85020673974&partnerID=8YFLogxK
U2 - 10.1177/1526924817699966
DO - 10.1177/1526924817699966
M3 - Article
C2 - 28617162
AN - SCOPUS:85020673974
SN - 1526-9248
VL - 27
SP - 200
EP - 206
JO - Progress in Transplantation
JF - Progress in Transplantation
IS - 2
ER -