Temporal trends of biochemical parameters in brain-dead patients

: INTRODUCTION Brain death is the irreversible cessation of brain function. Patho-physiological changes like hemodynamic instability,endocrine disturbances,hypothermia,coagulopathy,persiste nt hypoxemia and electrolyte imbalance are observed in brain-dead patients. A brain-dead organ donor provides a lifesaving opportunity to the recipient. Hence, earliest identification of brain death and effective correction of the above changes is required to optimize the harvest and enhance the survival of graft. With this in mind the study was undertaken to find out the pattern of changes occurring in the serum levels of common analytes. OBJECTIVES1. To analyze the biochemical parameters namely serum glucose,urea,creatinine,sodium and potassium in patients declared brain-dead in our hospital for a period of 19 months from January 2012 to July 2013. 2. To interpret the temporal raise or fall of serum glucose,urea,creatinine,sodium and potassium over a period of 24 hours following brain death. METHODS 42 patients aged between 20 and 40 years, admitted to our hospital and declared brain-dead after admission, were selected for the study. The biochemical parameters listed along with the methodology were analysed within the temporal trends, over a 24 hour period.1.Serum glucose by Glucose-Oxidase-Peroxidase method 2.Serum urea by DiacetylmonoximeThiosemicarbazide method 3.Serum creatinine by modified Jaffes method 4.Serum sodium potassium using ion selective electrode. RESULTS The average age of the study population was 29.34 6.8 years. Of the 42 patients 39 were males while 3 were females with head injury following a road traffic accident. During the 24-hour study period maximum incidence of hyperglycemia and hypokalemia was observed in the 3 to 6 hours samples. Serum urea, creatinine and sodium were invariably in the normal range. Elevated serum urea and sodium were more commonly observed during the 0 to 2 hour period. CONCLUSION Hyperglycemia, hypokalemia and hypernatremia are more frequently reported in brain-dead patients. Timely identification by frequent sampling and appropriate correction of these factors will improve the quality