Does Traumatic Brain Injury by Firearm Injury Accelerates the Brain Death Cascade? Preliminary Results

Abstract

Brain death (BD) triggers a series of pathophysiological events similar to multiple-organ dysfunction. Traumatic brain injury (TBI) due to firearm injury (FAI) causes lesions that could lead to BD. Patients admitted to the ICU due to severe TBI that evolved to BD were studied, including those caused by FAI; the 2 groups were compared with the objective of demonstrating that the support of the deceased donor by TBI due to FAI is more unstable and of shorter duration than the one related to TBI by another cause. Preliminary results demonstrated that the individuals with TBI by FAI died in BD in a higher percentage than the individuals with TBI caused by accidents (83% vs 41%). The donor treatment period was lower in individuals who presented TBI by FAI. These individuals needed higher doses of noradrenaline as vasopressor support for their treatment, without showing a statistically significant difference (P = .15), compared with individuals whose BD cause was TBI caused by accident.