Non-Invasive Cerebral Oximetry as Predictor of Cerebral Blood Flow Cessation in Potential Brain-Dead Donors

Abstract

The determination of brain death in adult organ donors usually includes confirmation with an instrumental test after the clinical diagnosis. The time interval between these two diagnostic steps varies widely and represents a significant source of stress for patients' families. We aim to explore whether cerebral oximetry monitoring using near-infrared spectroscopy (NIRS) is useful for predicting the absence of cerebral blood flow in potential organ donors after brain death, with the aim of providing more accurate information to families regarding waiting times. Case series presentation: Eight cases were included over a one-year period. Patients diagnosed with brain death whose relatives consented to organ and/or tissue donation. Acquisition of data on the temporal evolution of regional cerebral oxygen saturation between clinical diagnosis of brain death and its instrumental confirmation. The mean regional cerebral oxygen saturation was 66.8 ± 2.03% eight hours before the clinical diagnosis, 68.4 ± 1.0% at the time of clinical diagnosis, and 68.6 ± 1.5% at the time of instrumental confirmation. Cerebral oximetry using NIRS monitoring in this study was not useful for predicting the absence of cerebral blood flow in brain-dead organ donors. In clinical practice, monitoring organ donors with this technology is not relevant, as it does not contribute to reducing the family's waiting time.