Korean J Anesthesiol.  2014 Aug;67(2):133-138. 10.4097/kjae.2014.67.2.133.

Inhaled nitric oxide for the brain dead donor with neurogenic pulmonary edema during anesthesia for organ donation: a case report

• Park ES
• Son HW
• Lee AR
• Lee SH
• Kim AS
• Park SE
• Cho YW

• KMID: 2227416
• DOI: http://doi.org/10.4097/kjae.2014.67.2.133

Abstract

Neurogenic pulmonary edema (NPE) in brain dead organ donors occurring after an acute central nervous system insult threatens organ preservation of potential organ donors and the outcome of organ donation. Hence the active and immediate management of NPE is critical. In this case, a 50-year-old male was admitted to the intensive care unit (ICU) for organ donation. He was hypoxic due to NPE induced by spontaneous intracerebral hemorrhage and intraventricular hemorrhage. Protective ventilatory management, intermittent recruitment maneuvers, and supportive treatment were maintained in the ICU and the operating room (OR). Despite this management, the hypoxemia worsened after the OR admission. So inhaled nitric oxide (NO) therapy was performed during the operation, and the hypoxic phenomena showed remarkable improvement. The organ retrieval was successfully completed. Therefore, NO inhalation can be helpful in the improvement of hypoxemia caused by NPE in brain dead organ donors during anesthesia for the organ donation.

Keyword

Brain death; Nitric oxide; Organ donors; Organ retrieval; Pulmonary edema

MeSH Terms

Anesthesia*
Anoxia
Brain Death*
Central Nervous System
Cerebral Hemorrhage
Hemorrhage
Humans
Inhalation
Intensive Care Units
Male
Middle Aged
Nitric Oxide*
Operating Rooms
Organ Preservation
Pulmonary Edema*
Tissue and Organ Harvesting
Tissue and Organ Procurement*
Tissue Donors*
Nitric Oxide