SU1353420A1

SU1353420A1 - Method of diagnosis of brain death

Info

Publication number: SU1353420A1
Application number: SU853858796A
Authority: SU
Inventors: Раиса Ивановна Новикова; Владимир Ильич Черний; Алла Ивановна Антонова
Original assignee: Донецкий медицинский институт им.М.Горького
Priority date: 1985-02-20
Filing date: 1985-02-20
Publication date: 1987-11-23

Abstract

Изобретение относитс к медицине , а именно к реаниматологии. Дл повышени точности диагностики на фоне проводимой офтальмоскопии внутривен- но ввод т 0,5 - 1%-ный раствор кавин- тона .и через 1. - 2 мин внутривенно ввод т раствор индифферентного красител . При отсутствии окрашивани сосудов сетчатки в течение 5 - 10 с после введени красител диагностируют смерть мозга. оо ел ОЭ 4 N5The invention relates to medicine, namely to resuscitation. To improve the accuracy of diagnostics against the background of ophthalmoscopy, a 0.5-1% solution of cavinton is injected intravenously. In the absence of retinal vascular staining for 5 to 10 seconds after dye injection, brain death is diagnosed. oo ate oe 4 n5

Description

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Изобретение относитс к медицине, а именно к реаниматологии.The invention relates to medicine, namely to resuscitation.

Целью изобретени вл етс повышение точности определени за счет дополнительного исследовани кровотока в сетчатке глаза при введении кавинто- на и индифферентного красител .The aim of the invention is to improve the accuracy of determination due to the additional examination of the blood flow in the retina with the introduction of cavinton and an indifferent dye.

Способ осуществл ют следующим об- рйзом.The method is carried out as follows.

Больному, наход щемус в глубокой коме с адинамией и арефлексией, при необходимости подтвердить диагноз - смерть мозга, закапывают в глаза 0,5 - 1%-ный раствор атропина по 1 - 2 капли в конъюнктивальную полость и через 30 - 40 мин при расщиренном зрачке с помощью офтальмоскопа исследуют глазное дно. На фоне проводимой офтальмоскопии больному внутривенно ввод т 0,5 - 1%-ный раствор кавинто- на в дозе 0,1 - 0,2 мг/кг массы тела, а через 1 - 2 мин внутривенно ввод т 2 - 4%-ный раствор красител Т-1824 (синего Эванса) в дозе 1 - 2 мг/кг массы тела и подтверждают смерть мозга при отсутствии синего окрашивани сосудов сетчатки в течение 5 - 10 с после введени препарата Т-1824.Способ диагностики смерти мозга.A patient who is in a deep coma with adynamia and areflexia, if necessary, confirm the diagnosis of brain death, is instilled in the eyes with 0.5 - 1% solution of atropine 1 to 2 drops into the conjunctival cavity and after 30-40 minutes with the dilated pupil using the ophthalmoscope examine the fundus of the eye. Against the background of the ophthalmoscopy, 0.5–1% solution of cavinto- none is administered intravenously at a dose of 0.1–0.2 mg / kg body weight, and after 1–2 minutes, 2–4% is administered intravenously. a solution of dye T-1824 (Evans blue) at a dose of 1–2 mg / kg body weight confirms brain death in the absence of blue retinal vascular staining for 5–10 s after administration of the T-1824 preparation. Method for diagnosing brain death.

Пример. Больна Я, 35 лет, зо включающий клинические и инструмен- поступила в отделение реанимации пос- тальные методы исследовани , о т л и- ле левосторонней сальпингэктомии сExample. Ill, 35 years old, including clinical and instrumental, enrolled in the resuscitation department, follow-up research methods, on t of il left-sided salpingectomy with

тоды исследовани установили смерть мозга. Дл подтверждени диагноза бол1зной закапали в глаза 1%-ный растg вор атропина (по 2 капли в каждый глаз), затем через 40 мин после расширени зрачка с помощью офтальмоскопа исследовали глазное дно. На фоне проводимой офтальмоскопии больной внутривенно ввели 1%-ный раствор ка- винтона в дозе 0,2 мг/кг массы тела, а через 2 мин внутривенно ввели 4% раствор красител Т-1824 в дозе 2 мг/кг массы тела. При этом было установлено отсутствие синего окращи- вани сосудов сетчатки, что позволило подтвердить диагноз смерть мозга. Патологоанатомическое исследование подтвердило правильность диагноза - ткань мозга была жидкой консистенции (полный лизис мозгового вещества ) , просвет сосудов Виллизиево- |го круга заполнен плотными неизвлекающимис свертками крови темно-крас25 кого цвета.Research methods have established brain death. To confirm the diagnosis, a 1% dilution of atropine thief (2 drops in each eye) was dropped into the eyes, then 40 minutes after the pupil was dilated, an eye fundus was examined with an ophthalmoscope. Against the background of the patient's ophthalmoscopy, a 1% Cavinton solution at a dose of 0.2 mg / kg body weight was injected intravenously, and after 2 minutes, a 4% T-1824 dye solution was administered intravenously at a dose of 2 mg / kg body weight. At the same time, the absence of blue staining of retinal vessels was established, which made it possible to confirm the diagnosis of brain death. The pathologic examination confirmed the correctness of the diagnosis - the brain tissue was a liquid consistency (complete lysis of the brain substance), the lumen of the vessels of the Willis circle was filled with dense, incurable convolutions of blood of dark red color.

Claims

Invention Formula

20

Due to the fact that, in order to improve the accuracy of the determination, the blood flow in the retina is further examined by prior intravenous administration of Cavinton and an indifferent dye solution, and in the absence of retinal vascular staining for 5 to 10 seconds, brain death is confirmed.

postasystolic syndrome. The patient was in a comatose state on a ventilator without independent breathing. Despite intensive treatment, the depth of the comatose state increased, and the areflexes and adines developed, uncontrolled hypotonia. Clinic and Instrumental Instructors N. Gunko Order 5627/5.

Compiled by M. Sklovska Tehred M. Morgenthal,

Corrector C

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VNIIPI USSR State Committee

for inventions and discoveries 113035, Moscow, Zh-35, Raushsk nab., 4/5

Production and printing company, Uzhgorod, st. Project, 4

Method for the diagnosis of brain death.

Research methods have established brain death. To confirm the diagnosis, a 1% solution of atropine (2 drops in each eye) was dropped into the eyes of the bolus, and then 40 minutes after the pupil was dilated, the fundus of the eye was examined with an ophthalmoscope. Against the background of the patient's ophthalmoscopy, a 1% Cavinton solution at a dose of 0.2 mg / kg body weight was injected intravenously, and after 2 minutes, a 4% T-1824 dye solution was administered intravenously at a dose of 2 mg / kg body weight. At the same time, the absence of blue staining of retinal vessels was established, which made it possible to confirm the diagnosis of brain death. The pathologic examination confirmed the correctness of the diagnosis - the brain tissue was liquid consistency (complete lysis of the brain substance), the lumen of the vessels of the Willis circle was filled with dense, incurable convolutions of dark-colored blood.

Invention Formula

including clinical and instrumental methods of investigation,

In order to improve the accuracy of the determination, the blood flow in the retina is further examined by prior intravenous administration of Cavinton and an indifferent dye solution and in the absence of retinal vascular staining for 5-10 seconds confirm brain death.

Proofreader S. Shekmar