Avaliação do processo diagnóstico de morte encefálica: exames complementares e doação de órgãos

Abstract

The objective of this study was to analyze the diagnostic process of brain death (BD), to describe the confirmatory complementary tests (CT) and to characterize the profile of potential and effective donors of organs and tissues. This is an analytical and exploratory study, where data from medical records of 206 patients, potential organ donors (POD) and / or effective organ donors (EOD), between 2013 and 2016. The analysis was done by chi-square test, t-test of students, Kruskall-Wallis and Mann-Whitney tests. Male subjects predominated (62%), with a mean age of 40.4 years (16.6), the main cause of BD being head trauma (44.5%), followed by the stroke (43.6%). Regarding CT, transcranial Doppler (TCD) and digital subtraction cerebral angiography (CA) was used in the confirmation of BD in 82.3% and 16.2% of the cases, respectively. During the BD protocol, there was no significant difference (p=0,760) in the interval in hours from the beginning to the confirmatory CT, between the group that performed the TCD (10.58  7.07) and those who performed CA (9.97  5,70), as there wasn’t too (p=0,977) for the conclusion of the BD protocol between the same groups, (16.22  10.67) and (16.82  12.57), respectively. 179 cases of BD were confirmed, with 154 families interviewed regarding the desire to donate the organs of their deceased relative. Of these, 58.4% agreed and 54.5% of the total POD were EOD. The results show that, despite presenting parameters compatible with different regions of the state of Minas Gerais and Brazil, the service evaluated presented some indicators lower than the national average and most of the developed countries, highlighting the low rate of POD identification. The intervals for performing the confirmatory CT and for completing the BD protocol in the service evaluated presented similar results to the national and international scenarios. The TCD presented execution time and resolvability similar to the gold standard, having been an effective tool in the diagnosis of BD.