{'fraction_non_alphanumeric': 0.032467532467532464, 'fraction_numerical': 0.0010822510822510823, 'mean_word_length': 5.880893300248139, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Advanced Assessment of Hemodynamic Parameters during Donor Care

1 general assessment and treatment guidelines were recommended for treatment of increased blood pressure and hypotension during care of organ donors. Those guidelines emphasized continuous attention to maintaining intravascular volume (preload) as estimated by the central venous pressure (CVP) and pulmonary artery occlusion pressure (PAOP). Secondarily, positive inotropic (ie, dopamine, dobutamine, thyroid hormone) or vasopressor (ie, norepinephrine, phenylephrine) medications were recommended if preload support alone was insufficient to maintain a mean arterial blood pressure above 65 mm Hg. This fundamental principle of first ensuring adequate preload (intravascular volume) should always be followed. However, the organ procurement coordinator (OPC) may have the opportunity or clinical need to assess other components of the donor’s cardiovascular response. In this article, we discuss these assessment methods and their implications for more precisely directed therapy. Hemodynamic Profiles Advanced hemodynamic “profiling” is commonly performed in intensive care units (ICUs) by the bedside nurse. Various terminology has been applied to this process, including “hemocalculations,” “hemodynamic profiles,” and “cardiac profiles.” The bedside nurse manually enters or initiates the process wherein the bedside monitor records several primary physiological variables, such as heart rate; systolic, diastolic, and mean arterial blood pressure; CVP; cardiac output; body weight and height; and PAOP. The bedside monitor then calculates a series of other variables derived from these primary data. Obviously, the accuracy of the primary information determines the validity of the arithmetically produced profile. The procedures to ensure accuracy of the “input” data depend on proper “leveling,” “zeroing,” and functioning of the transducer; performance of the method for measuring cardiac output; and correct attachment of cables to the monitor, monitor amplifier, and internal data processing unit. Because the OPC does not ordinarily perform this procedure, details of the technical process for obtaining a “profile” will not be further discussed. The measured and calculated variables and normal values for each are shown in the Table. These values may be expressed either as “indexed” or “nonindexed.” The indexed value is the calculated variable divided by the body surface area (BSA) and is indicated by the “I” following the abbreviation, for example, SVRI (systemic vascular resistance index). This further mathematical step allows standardization of the variable for patients of different sizes (height and weight) so that a Advanced assessment of hemodynamic parameters during donor care