Analysis of brain death declaration process and its impact on organ donation in a reference trauma center.

OBJECTIVE: To characterize the processes of brain death diagnosis and organ donation in a reference trauma center. METHODS: Observational and cross-sectional study with patients notified with brain death at a reference trauma center. Data were obtained through the collection of medical records and brain death declaration forms. RESULTS: One hundred fity-nine patients were notified with brain death, mostly male (82.6%), young adults (97.61%) and victims of brain traumatic injury (93.7%). Median of the total time interval for the diagnosis of brain death was 20.75 hours, with no difference between organ donors and non-donors. We had excessive time intervals on brain death declaration, but without statistical effect on organ donation numbers. CONCLUSION: We had low efficacy in brain death declaration based on longer time intervals, with no impact on organ donation.

Analysis of brain death declaration process and its impact on organ donation in a reference trauma center / Análise do processo de declaração de morte encefálica e seu impacto na doação de órgãos em um centro de referência em trauma

ABSTRACT Objective To characterize the processes of brain death diagnosis and organ donation in a reference trauma center. Methods Observational and cross-sectional study with patients notified with brain death at a reference trauma center. Data were obtained through the collection of medical records and brain death declaration forms. Results One hundred fity-nine patients were notified with brain death, mostly male (82.6%), young adults (97.61%) and victims of brain traumatic injury (93.7%). Median of the total time interval for the diagnosis of brain death was 20.75 hours, with no difference between organ donors and non-donors. We had excessive time intervals on brain death declaration, but without statistical effect on organ donation numbers. Conclusion We had low efficacy in brain death declaration based on longer time intervals, with no impact on organ donation.

RESUMO Objetivo Caracterizar os processos de diagnóstico de morte encefálica e doação de órgãos em um centro de referência de trauma. Métodos Estudo observacional e transversal com pacientes notificados com morte encefálica em um centro de referência de trauma. Os dados foram obtidos por meio da coleta de prontuários e formulários de declaração de morte encefálica. Resultados Foram notificados com morte encefálica 159 pacientes, com prevalência do sexo masculino (82,6%), adultos jovens (97,61%) e vítimas de traumatismo craniencefálico (93,7%). A mediana do intervalo total de tempo para o diagnóstico de morte encefálica foi de 20,75 horas, sem diferença entre doadores de órgãos e não doadores. Tivemos intervalos de tempo excessivos na declaração de morte encefálica, mas sem efeito estatístico no número de doações de órgãos. Conclusão Foi baixa a eficácia na declaração de morte encefálica com base em intervalos de tempo mais longos, sem impacto na doação de órgãos.

Avaliação da eficácia do diagnóstico de morte encefálica e do processo de doação de órgão em um hospital de referência no Estado do Pará / Evaluation of the effectiveness of the diagnosis of brain death and the organ donation process in a reference hospital in the State of Pará

A constatação clinica de morte encefálica (ME) é essencial na obtenção de órgãos para transplante, sendo este uma medida terapêutica e extrema relevância, pois é a única alternativa para pacientes portadores de determinadas doenças terminais. O objetivo do trabalho foi caracterizar os processos de diagnostico de ME e de doação de órgãos no hospital Metropolitano de Urgência e Emergência. O estudo desenvolvido foi observacional, transversal e descritivo. Os pesquisadores utilizaram prontuários, termos de declaração de ME e protocolos de doação de órgãos de 159 pacientes diagnosticados com ME entre os anos de 2014 e 2017. Foram coletados dados epidemiológicos e informações concernentes aos processos de diagnóstico de ME, de manutenção do potencial doador (PD) e de doação de órgãos. A maioria dos pacientes pertencia ao gênero masculino (87,5%). encontrava-se na faixa etária de 21 a 40 anos (52,8%) e era proveniente do interior do Estado (85%). O acidente motociclístico foi o principal motivo de admissão (38,36%). Em acréscimo, identificou-se demora considerável no processo de diagnostico de ME, com poucos pacientes (28,3%) evoluindo sem complicações clínicas durante a internação. Evidenciou-se também que as principais causas de recusa para doação foram: desejo de corpo integro (32,04%) e motivos familiares (25,24%). Conclui-se, dessa forma, que o processo de doação de órgãos apresenta dificuldades no que se refere ao diagnostico e à manutenção do PD e à aceitação familiar, o que pode ser sanado com melhor educação tanto dos profissionais quanto dos cidadãos (AU)

The clinical establishment of brain death (BD) is essential for obtainment of organs for transplantation, which is a therapeutic measure and extremely relevant, as it is the only alternative for patients with certain terminal illnesses. The objective of this work was to characterize the processes of diagnosis of BD and organ donation in the Metropolitan Hospital of Urgency and Emergency. The study developed was observational, cross-sectional and descriptive. The researchers used medical records, BD declaration terms and organ donation protocols from 159 patients diagnosed with BD between 2014 and 2017. Epidemiological data and information concerning the processes of BD diagnosis and maintenance of potential donors were collected ( PD) and organ donation. Most patients were male (87.5%). he was aged between 21 and 40 years (52.8%) and came from the interior of the state (85%). Motorcycle accidents were the main reason for admission (38.36%). In addition, a considerable delay in the BD diagnosis process was identified, with few patients (28.3%) evolving without clinical complications during hospitalization. It was also evident that the main causes of refusal to donate were: desire for a whole body (32.04%) and family reasons (25.24%). Thus, it is concluded that the organ donation process presents difficulties with regard to the diagnosis and maintenance of PD and family acceptance, which can be remedied with better education of both professionals and citizens

Antioxidant effects of açaí seed ( Euterpe oleracea ) in anorexia-cachexia syndrome induced by Walker-256 tumor.

PURPOSE:: To assess antioxidant effects of açaí seed extract on anorexia-cachexia induced by Walker-256 tumor. METHODS:: A population of 20 lab rats were distributed into four groups (n=5): Control Group (CG), which only received tumor inoculation. Experimental Group-100 (EG-100), with animals submitted to tumor inoculation and treated with seed extract in a 100 mg / ml concentration through gavage. Experimental Group-200 (EG-200), with animals submitted to tumor inoculation and treated with seed extract in a 200 mg / ml concentration. Placebo Group (GP), which received tumor inoculation and ethanol-water solution. We analyzed proteolysis, lipid peroxidation, tumor diameter and weight. RESULTS:: Lipid peroxidation was representative only in the cerebral cortex, where there was more oxidative stress in rats treated with the extract (p = 0.0276). For proteolysis, there was less muscle damage in untreated rats (p = 0.0312). Only tumor diameter in treated rats was significantly lower (p = 0.0200) compared to untreated ones. CONCLUSIONS:: The açaí seed extract showed no beneficial effect on the general framework of the cachectic syndrome in lab rats. However, some anticarcinogenic effects were observed in the tumor diameter and weight.

Antioxidant effects of açaí seed ( Euterpe oleracea ) in anorexia-cachexia syndrome induced by Walker-256 tumor

ABSTRACT PURPOSE: To assess antioxidant effects of açaí seed extract on anorexia-cachexia induced by Walker-256 tumor. METHODS: A population of 20 lab rats were distributed into four groups (n=5): Control Group (CG), which only received tumor inoculation. Experimental Group-100 (EG-100), with animals submitted to tumor inoculation and treated with seed extract in a 100 mg / ml concentration through gavage. Experimental Group-200 (EG-200), with animals submitted to tumor inoculation and treated with seed extract in a 200 mg / ml concentration. Placebo Group (GP), which received tumor inoculation and ethanol-water solution. We analyzed proteolysis, lipid peroxidation, tumor diameter and weight. RESULTS: Lipid peroxidation was representative only in the cerebral cortex, where there was more oxidative stress in rats treated with the extract (p = 0.0276). For proteolysis, there was less muscle damage in untreated rats (p = 0.0312). Only tumor diameter in treated rats was significantly lower (p = 0.0200) compared to untreated ones. CONCLUSIONS: The açaí seed extract showed no beneficial effect on the general framework of the cachectic syndrome in lab rats. However, some anticarcinogenic effects were observed in the tumor diameter and weight.