{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:08:44Z","timestamp":1789477724166,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2012,6,1]],"date-time":"2012-06-01T00:00:00Z","timestamp":1338508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Circulatory instability is a serious problem after brain death in organ donors. The hypotension is often counteracted with infusion of large amounts of crystalloid solutions, which may impair lung function leading to rejection of the lungs as donor organs. The aim was to show that the circulation can be normalized pharmacologically for 24\u2009h in pigs after total removal of the brain and brainstem by decapitation (between <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>2 and <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010four 40\u2010kg pigs (<jats:italic><jats:styled-content style=\"fixed-case\">n<\/jats:styled-content><\/jats:italic>\u2009=\u20098\u2009\u00d7\u20093) were included: non\u2010decapitated, decapitated, and decapitated with pharmacological treatment. All animals got the same basal fluid supply and ventilation. The pharmacological treatment consisted of the neuronal monoamine reuptake blocker cocaine and low doses of noradrenaline and adrenaline. Desmopressin, triiodothyroxine, thyroxine and cortisol were also given.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After decapitation, a catecholamine storm occurred, with an increase of noradrenaline and adrenaline by a factor of 79 and 298, respectively. Thirty minutes later, the pigs were hypotensive. The median time to the aortic pressure that was less than 40\u2009mmHg was 9:09\u2009h (range 5:50 to 22:01). After 6\u2009h, the concentration of thyroid hormones and cortisol was significantly reduced. With pharmacological treatment of decapitated animals, the aortic pressure, renal blood flow, creatinine, urine production, liver function and blood gases did not differ significantly from the non\u2010decapitated control animals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pharmacological substitution of pituitary gland function, blockade of peripheral catecholamine neuronal reuptake and low doses of catecholamines normalize circulation in decapitated pigs throughout a 24\u2010h observation period, whereas untreated decapitated pigs all develop severe circulatory collapse within 12\u2009h.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1399-6576.2012.02721.x","type":"journal-article","created":{"date-parts":[[2012,6,1]],"date-time":"2012-06-01T10:59:25Z","timestamp":1338548365000},"page":"1006-1012","source":"Crossref","is-referenced-by-count":32,"title":["Pharmacological normalization of circulation after acute brain death"],"prefix":"10.1111","volume":"56","author":[{"given":"S.","family":"STEEN","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery Lund University Hospital and Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"SJ\u00d6BERG","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Lund University Hospital and Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"LIAO","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Lund University Hospital and Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"BOZOVIC","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging and Clinical Physiology Lund University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"WOHLFART","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Lund University Hospital and Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2008.01607.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2008.01606.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2008.01879.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"crossref","unstructured":"BarklinA.Systemic inflammation in the brain\u2010dead organ donor. 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