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Intensive Care Medicine

, Volume 18, Issue 8, pp 493–495 | Cite as

Hemodynamic responses to noxious stimuli in brain-dead organ donors

  • H. -J. Gramm
  • J. Zimmermann
  • H. Meinhold
  • R. Dennhardt
  • K. Voigt
Case Reports

Abstract

The case report presents evidence for the spinal origin of the marked hypertensive reponses to noxious stimuli that may occur in organ donors who fulfill the commonly accepted criteria of brain death. Cardiovascular spinal reflex activity does not invalidate these criteria. For the first time, the catecholamine plasma concentrations have been determined during spinal pressor reflex activity. Circulating epinephrine increased more markedly than norepinephrine in both cases, rising to 4.7 and 44 times the baseline concentration respectively. The relation between plasma norpinephrine and epinephrine suggests involvement of the adrenal medulla in the reflex arc. The literature on spinal hemodynamic reflexes is reviewed.

Key words

Brain death Spinal reflexes and automatisms Organ donor 

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Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • H. -J. Gramm
    • 1
  • J. Zimmermann
    • 1
  • H. Meinhold
    • 2
  • R. Dennhardt
    • 3
  • K. Voigt
    • 4
  1. 1.Department of Anesthesiology and Critical Care Medicine, Steglitz Medical CenterFree University of BerlinBerlinFRG
  2. 2.Department of Nuclear Medicine, Steglitz Medical CenterFree University of BerlinBerlinFRG
  3. 3.Department of AnesthesiologyNordwest HospitalFrankfurt/MainFRG
  4. 4.Department of PhysiologyPhilipps UniversityMarburgFRG

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