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DBD Doner - Coggle Diagram
DBD Doner
Pathophysiology
CVS
pontine ischaemia = catecholamine storm
HTN + bradycardia = Cushings reflex
Foramen magnum herniation = loss of sympathetic tone
Respiratory
Pulmonary oedema
Apnoea
Endocrine
Pituatary ischaemia = cranial DI
Hypothalamic dysfunction= hypothermia +functional hypothyroidism
Management
CVS
Parameter
SBP>100
PCWP 10-15
CI>2.1
Sv02 >60%
CVP6-10
SVRI 1800-2400
HR 60-120
Drugs
Vasopressin
Dopamine
Respiratory
Parameters
pH 7.35-45
pa02>10
paC02 4.5-6
Sats >94%
Ventilation
Lung recruitment
4-8mls/kg
OPtimum PEEP
Peak pressures <30
Head 30-45 degrees
Endocrine
Parameters
Temp 36-37.5
Blood glucose 4-10
Na<155
Drugs
methyprednisalone 15mg/kg
Insulin infusion
5% destrose
Desmopressin 0.5-4mcg IV
Cranial DI
Definition
UO>4ml/kg/hr
Serum sodium >145
Serum osmolility >300
Urine osmolality <200