Temporal trends of biochemical parameters in brain-dead patients.

Abstract

INTRODUCTION Brain death is
the irreversible cessation of brain function.
Patho-physiological changes like hemodynamic
instability,endocrine disturbances,
hypothermia,coagulopathy,persiste
nt hypoxemia and electrolyte imbalance
are observed in brain-dead patients. A
brain-dead organ donor provides a lifesaving
opportunity to the recipient. Hence,
earliest identification of brain death and
effective correction of the above changes
is required to optimize the harvest and enhance
the survival of graft. With this in
mind the study was undertaken to find out
the pattern of changes occurring in the serum
levels of common analytes. OBJECTIVES1.
To analyze the biochemical paramet
er s namely serum glucose,
urea,creatinine,sodium and potassium
in patients declared brain-dead in our
hospital for a period of 19 months from
January 2012 to July 2013. 2. To interpret
the temporal raise or fall of serum glucose,
urea,creatinine,sodium and potassium
over a period of 24 hours following
brain death. METHODS 42 patients aged
between 20 and 40 years, admitted to our
hospital and declared brain-dead
after admission, were selected for the
study. The biochemical parameters listed
along with the methodology were analysed
within the temporal trends, over a
24 hour period.1.Serum glucose by Glucose-
Oxidase-Peroxidase method
2.Serum urea by DiacetylmonoximeThiosemicarbazide
method 3.Serum creatinine
by modified Jaffes method 4.Serum sodium
potassium using ion selective electrode.
RESULTS The average age of the
study population was 29.34 6.8 years. Of
the 42 patients 39 were males while 3
were females with head injury following a
road traffic accident. During the 24-hour
study period maximum incidence of hyperglycemia
and hypokalemia was observed
in the 3 to 6 hours samples. Serum
urea, creatinine and sodium were invariably
in the normal range. Elevated serum
urea and sodium were more commonly
observed during the 0 to 2 hour period.
CONCLUSION Hyperglycemia, hypokalemia
and hypernatremia are more
frequently reported in brain-dead patients.
Timely identification by frequent sampling
and appropriate correction of these factors
will improve the quality

of the organs to be transplanted.