3 years ago

Niveles de capnometría como indicador de evolución de injerto renal de donantes en asistolia no controlada

A. Mateos Rodríguez, D. Varillas Delgado, A. Villar Arias, C. Rubio Chacón, A. Andrés Belmonte

Publication date: Available online 8 January 2019

Source: Medicina Intensiva

Author(s): A. Mateos Rodríguez, D. Varillas Delgado, A. Villar Arias, C. Rubio Chacón, A. Andrés Belmonte

Resumen
Objetivo

Los valores de capnometría durante la resucitación son un factor predictor de la evolución de los riñones obtenidos a partir de donantes en asistolia no controlada.

Diseño

Cohorte de comienzo retrospectivo de 37 donantes en asistolia y cohorte de validación de 55 trasplantados de riñón, entre 2013-2017.

Ámbito

Población atendida por el servicio de urgencias y derivada al Hospital Universitario 12 de Octubre, Madrid, como potenciales donantes en asistolia no controlada.

Pacientes

Cincuenta y cinco trasplantados renales con hemodiálisis, procedentes de donantes en asistolia no controlada.

Intervenciones

Determinaciones de capnometría y capnografía en pacientes candidatos a donación en asistolia no controlada.

Variables

Calores de capnometría inicial y en el momento de la transferencia en el hospital para su comparación con la viabilidad de los riñones extraídos; fallo renal y retraso en función renal.

Resultados

Treinta y siete potenciales donantes de los que se consiguen 30 utilizados, de los cuales se trasplantan 55 riñones. El resto de ellos fueron descartados por mala perfusión o signos de isquemia. Se encontró una asociación (p = 0,016) entre valores de capnometría durante la resucitación en los donantes utilizados (μ = 22,8 mmHg) frente a los donantes no utilizados para el trasplante (μ = 17,35 mmHg).

Conclusiones

Se ha demostrado que los valores de capnometría durante las maniobras de resucitación ofrecen un marcador a tener en cuenta en relación con la viabilidad de los órganos a trasplantar en la donación en asistolia no controlada.

Abstract
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 (μ=22.8 mmHg) and in the kidneys discarded for transplantation (μ=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.

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