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KMID : 0390320180280010027
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Chungbuk Medical Journal
2018 Volume.28 No. 1 p.27 ~ p.32
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Long Term Survival in Brain Death Patient with Hormone Replacement Therapy
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Kang Hye-Ran
Shin Yoon-Mi
Lee Sung-Hyun
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Abstract
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After cardiopulmonary resuscitation, even in patient who recovered of systemic circulation, hypoxic brain damage is relatively common. Brain death is most severe form of hypoxic brain damage. Survival of brain death patient has been reported about several days, usually within 7days. But we experienced an 82 year old patient who was diagnosed with brain death and survived for 85 days. In primary clinic, an 82 year old man received fentanyl and propofol for sedation to perform vertebroplasty. After 10min, respiratory arrest occurred. The physician and emergency medical technician did cardiopulmonary resuscitation, and he showed recovery of systemic circulation. He was tranferred to Chungbuk national
university hospital and was admitted into intensive care unit(ICU). We started normothermia therapy and maintained sedation for 3 days. After normothermia therapy, we performed electroencephalography but there was no meaningful wave in whole recording period. His mental status sustained comatous and self respiration wasn’t noted in apnea test. He was diagnosed with brain death but we couldn’t withdraw aggressive treatment due to possibility of legal problem. We checked his hormonal status and he showed panhypopituitarism secondary to brain damage. We replaced prednisolon, levothyroxine and vasopressin and he survived during 60 days in our ICU. We transferred him to Cheongju medical center and he died after 2 weeks. We think that his long term survival was attributed to hormonal replacement therapy and suggest checking hormone level and replacement in the potential organ donor with brain death.
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KEYWORD
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Cariopulmonary resuscitation, Brain death, Hormone replacement therapy, Survival
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