A standardized model of brain death, donor treatment, and lung transplantation for studies on organ preservation and reconditioning

Valenza, Franco; Coppola, Silvia; Froio, Sara; Ruggeri, Giulia Maria; Fumagalli, Jacopo; Villa, Alessandro Maria; Rosso, Lorenzo; Mendogni, Paolo; Conte, Grazia; Lonati, Caterina; Carlin, Andrea; Leonardi, Patrizia; Gatti, Stefano; Stocchetti, Nino; Gattinoni, Luciano

doi:10.1186/2197-425X-2-12

Intensive Care Medicine Experimental

Table 1 Donor parameters

From: A standardized model of brain death, donor treatment, and lung transplantation for studies on organ preservation and reconditioning

	Baseline	Brain death diagnosis	Treatment	Procurement	P value
Temperature, °C	36.3 ± 0.9	37.7 ± 1.3^a	37.9 ± 1.2^a	38.2 ± 0.7^a	<0.05
Heart rate, beats/min	100 ± 20	129 ± 38^a	145 ± 28^a	163 ± 17^ab	<0.05
Mean arterial pressure, mmHg	75 ± 10	56 ± 8	68 ± 13	75 ± 10	<0.05^*
Pulmonary artery pressure, mmHg	18 ± 3	21 ± 4	19 ± 4	21 ± 4	0.100
Wedge pressure, mmHg	11 ± 3	13 ± 3	14 ± 1	13 ± 2	0.392
Central venous pressure, mmHg	5 ± 3	7 ± 3	7 ± 3	8 ± 3^a	<0.05
Cardiac output, L/min	2.9 ± 0.2	3.5 ± 0.6	4.4 ± 1.1^a	5.1 ± 0.8^ab	<0.05
Systemic vascular resistance, dyn · s · cm⁻⁵	1,900 ± 269	1,146 ± 187^a	1,127 ± 156^a	1,051 ± 177^a	<0.05
Pulmonary vascular resistance, dyn · s · cm⁻⁵	195 ± 119	180 ± 65	100 ± 87	134 ± 79	0.103
Stroke volume variation, %	9 ± 2	10 ± 3	12 ± 5	11 ± 4	0.326
Global end diastolic volume, mL	360 ± 53	361 ± 76	394 ± 74	416 ± 108	0.564
Fluid balance, mL	−507 ± 1,249	201 ± 1,360	399 ± 1,396	350 ± 1,707	0.136
Urine output, mL/Kg/h	5.2 ± 1.8	3.1 ± 0.6	8.3 ± 12.5	7.8 ± 5.2	0.521
Lactate, mmol/L	1.7 ± 0.5	2.1 ± 0.8	2.5 ± 2.3	4.8 ± 1.8	<0.05^*
Oxygen delivery, mL/min	282 ± 31	285 ± 65	411 ± 95	483 ± 113^ab	<0.05
Respiratory rate, breaths/min	14 ± 3	17 ± 2^a	19 ± 3^a	19 ± 3^ab	<0.05
Tidal volume, mL	328 ± 50	284 ± 30^a	286 ± 23^a	288 ± 21^a	<0.05
Peak airway pressure, cmH₂O	17 ± 1	19 ± 1	22 ± 2^a	23 ± 2^ab	<0.05
Plateau airway pressure, cmH₂O	12 ± 1	13 ± 1	14 ± 1	14 ± 1	0.061
Mean airway pressure, cmH₂O	8 ± 0	11 ± 0^a	12 ± 1^a	12 ± 2^a	<0.05
Positive end-expiratory pressure, cmH₂O	5 ± 0	7 ± 1^a	8 ± 2^a	8 ± 2^a	<0.05
End-tidal CO₂, mmHg	43.0 ± 7.6	48.5 ± 6.4	48.9 ± 4.6	51.3 ± 2.8^a	<0.05
PaCO₂, mmHg	40.5 ± 5.7	45.6 ± 3.2	43.6 ± 2.5	45.6 ± 5.2	0.168
pH	7.429 ± 0.036	7.411 ± 0.046	7.402 ± 0.057	7.358 ± 0.057	0.127
Glucose, g/dL	169 ± 56	147 ± 45	160 ± 82	162 ± 55	0.472
Na⁺, mEq/L	137.0 ± 4.3	137.6 ± 6.1	141.2 ± 4.1	144.2 ± 5.3^ab	<0.05
K⁺, mEq/L	4.2 ± 0.5	4.5 ± 0.5	4.2 ± 0.3	4.0 ± 0.1	0.375
Ca⁺⁺, mEq/L	1.26 ± 0.01	1.18 ± 0.09	1.19 ± 0.06	1.17 ± 0.04^a	<0.05
Cl⁻, mEq/L	99.6 ± 2.5	98.6 ± 3.5	101.4 ± 2.9	106.0 ± 5.0^abc	<0.05
Na⁺_urinary, mEq/L	64.3 ± 20.4	60.8 ± 31.7	19.7 ± 18.2	7.3 ± 7.3^ab	<0.05
K⁺_urinary, mEq/L	29.5 ± 7.3	53.7 ± 23.2	23.2 ± 19.6	6.4 ± 3.3^b	<0.05
pH_urinary	6.610 ± 0.320	6.821 ± 0.132	6.741 ± 0.631	6.229 ± 0.512	0.182
Specific gravity_urinary	1.016 ± 2.5	1.011 ± 2.8	1.005 ± 0.0	1.006 ± 7.6^a	<0.05

Table 1 shows respiratory, hemodynamic, and metabolic parameters and urinary electrolytes of donor pigs collected at the end of surgery (baseline), after the induction and diagnosis of brain death (brain death diagnosis), 3 h after brain death confirmation (treatment), and at procurement (procurement, 9 h after brain death induction). Data are presented as mean ± standard deviation. One-way ANOVA repeated measures. P < 0.05 accepted as significant: ^avs. Baseline, ^bvs. Brain Death, and ^cvs. 3 h. *P < 0.05: When we tested the differences of main arterial pressure between the time points considered, a statistically significant difference was found (P < 0.05). To isolate the group or groups that differ from the others, a multiple comparison procedure was used (Bonferroni t test). The statistical software we used (Sigma Stat) is such that when no significant difference is found between the two groups with the higher difference of mean values, a result of ‘Do Not Test’ is provided by Bonferroni t test for the all other enclosed comparison. A ‘Do Not Test’ should be treated as if there is no significant difference between the means, even though the ANOVA test indicates that this is the case. This apparent discrepancy is due to the fact that differences are close to significance (P = 0.06) but below threshold (set at 0.05). This result may therefore be considered only as a nonsignificant trend.

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