4.1 Article

Capnometry levels as an indicator of renal graft evolution in uncontrolled non-heart beating donors

Journal

MEDICINA INTENSIVA
Volume 44, Issue 4, Pages 233-238

Publisher

ELSEVIER ESPANA SLU
DOI: 10.1016/j.medin.2018.10.008

Keywords

Capnometry; Kidney transplantation; Asystole; Resuscitation; Emergency services

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Objective: The capnometry values during resuscitation are an evolutive predictor of kidneys obtained from uncontrolled non-heart beating donors. Design: The study comprised a retrospective onset cohort of 37 non-heart beating donors and a validation cohort of 55 trasplanted kidneys in the period 2013-2017. Scope: The population served by the emergency service and referred to Hospital Universitario Doce de Octubre (Madrid, Spain) as potential uncontrolled non-heart beating donors. Patients: A total of 55 renal transplant patients subjected to hemodialysis and with grafts from uncontrolled non-heart beating donors. Interventions: Capnometry and capnography measurements in potential uncontrolled non-heart beating donors. Variables: Capnometry values recorded initially and at transfer in hospital for comparison with the viability of the extracted kidneys; renal failure and delayed renal function. Results: A total of 55 out of 74 extracted kidneys were trasplanted (74.3%). The rest were ruled out due to poor perfusion or signs of ischemia. An association was observed (P=.016) between the capnometry values during resuscitation in the grafted kidneys (mu=22.8 mmHg) and in the kidneys discarded for transplantation (mu=17.35 mmHg). Conclusions: Capnometry during resuscitation serves as a marker to be taken into account in relation to the viability of the trasplanted organs in uncontrolled non-heart beating donors. (C) 2018 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.

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