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"BRAIN DEATH":HEMODYNAMIC ASPECTS Ryohei Yamada 1 , Tokuo Minami 1 , Ichiro Tahara 1 , Michio Ogawa 1 , Kikushi Katsurada 1 , Tsuyoshi Sugimoto 1 1Department of Traumatology, Osaka University Medical School pp.257-264
Published Date 1973/3/1
DOI https://doi.org/10.11477/mf.1406203283
  • Abstract
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Hemodynamic changes in the patients with severe head injury were studied with special reference tothe state of so-called "brain death". Following results were obtained :

1) Significant decrease in the cardiac output was occurred at the moment of brain death concomitant-ly with the fall of blood pressure. Decrease of total peripheral resistance occurred simultaneously or there were short time lag to the decrease in cardiac output.

2) The prolonged mean transit time was asso-ciated with the reduction of the cardiac output in the brain death.

3) Noradrenalin was the only effective agent to maintain the blood pressure of patients in the brain death. It improved the venous return curve, though only little effects on the ventricular function curve were observed.

4) Isoproterenol had little effects on the ven-tricular function curve. No raise in the blood pres-sure nor change in venous return curve, were observed after the injection of isoproterenol.

5) There was no compensatory reaction in cardiac output to the respiratory dysfunction in brain death state.

Thus, both the cardiac function and peripheral circulatory state were deteriorated in the brain death. Normal reaction in the hemodynamic state could not occur.

We could conclude that the state of brain death is not only the dysfunction of brain, but also the deterioration of the hemodynamic reaction. The blood pressure is maintained by the drip of large doses of noradrenalin and the heart continued to beat by its automaticity, but whole vital reactions are disappeared at the state of brain death.


Copyright © 1973, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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