Date of Award
Doctor of Nursing Practice (DNP)
Pamela Schwartz, DNP, CRNA
Background: There is a large disparity between the number of people waiting for organ transplants and the number of organs available. Optimal hemodynamic management can influence transplant outcomes, therefore evidence-based hemodynamic management should be practiced to maximize scarce donor organs.
Purpose: The purpose of this study was to examine intraoperative blood pressures and administration of volatile anesthetics during brain dead organ donor procurements. Use of volatile anesthetics was examined to determine how use and dose affected the ability to maintain mean arterial pressure (MAP) between 60 to 90 mmHg.
Design: This study was a retrospective chart review.
Results: Twenty-eight cases were analyzed using the mean MAP calculated for each donor. Mean scores ranged from 61.04 to 99.34 mmHg with a mean of M= 84.51 mmHg. Twenty-two donors (78.6%) received volatile anesthetic gas, and six donors (21.4%) received no volatile anesthetic gas. Mean end-tidal concentrations of volatile anesthetic gas in the 22 donors who received volatile anesthetic gas ranged from 0 to 1.25% with a mean end-tidal concentration of M= 0.39%. Mean MAP in donors that did not receive volatile anesthetic gas was M= 78.49 mmHg (SD= 9.78 mmHg). Mean MAP in donors that received volatile anesthetic gas was M= 86.16 mmHg (SD= 7.02 mmHg). An independent samples t test performed between these two groups demonstrated that the difference between mean MAPs of the two groups was statistically significant (t= 2.182, p= 0.038), but no statistically significant correlation was found between mean MAP and mean end-tidal volatile anesthetic gas (rs= -0.184, p=0.414).
Conclusions: This study demonstrated that intraoperative hypertension is more prevalent than intraoperative hypotension, and volatile anesthetic gas is often used at this medical center during organ procurements at relatively low concentrations.
Karmanian, Alison Lynn, "Intraoperative Blood Pressure and Effect of Volatile Anesthetic in Brain Dead Organ Donors" (2017). College of Science and Health Theses and Dissertations. 216.