The Impact of CBIGs on Achievement of Donor Management Goals at a Level 1 Trauma Center L. Quinn, J.P. Orlowski, W. McTague, C.A. Jones Center for Donation & Transplant Albany, New York

Introduction & Aim of Study Introduction of Catastrophic Brain Injury Guidelines (CBIGs) at Level 1 Trauma Center in 2006 Introduction of Catastrophic Brain Injury Guidelines (CBIGs) at Level 1 Trauma Center in 2006 –Developed by Director of MICU and SICU –Standards of care in Guidelines –Reference tool Aim of Study Aim of Study –Did CBIGs impact the achievement of Donor Management Goals (DMGs) in adult brain dead donors?

Material and Methods Retrospective analysis of DMGs met before and after CBIGs implemented Retrospective analysis of DMGs met before and after CBIGs implemented N=133 N=133 –67 donors in pre-CBIGs data o January 2001 – February 2006 –66 donors in post-CBIGs data o March 2006 – December 2010

Donor Management Goals Systolic BP > 100mm 1 or less Urine 1-2cc kg/hr pO 2 > 100 Na < 160 pH within normal limits Temperature Arterial line in place Central line in place with monitor

Results After CBIGs were implemented: After CBIGs were implemented: –78% of individual DMGs met more often –Increase in goal achievement ranged from 4% to 33% –1 goal was met at the same rate –Two goals were met less often in post-CBIGs data

DMGs Met Pre & Post CBIGs

Results

Conclusions Positive relationship between use of CBIG’s prior to brain death and goals met post-BD Positive relationship between use of CBIG’s prior to brain death and goals met post-BD Decline in success rate of p0 2 and pH Decline in success rate of p0 2 and pH Better managed patients = more stable donors Better managed patients = more stable donors

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