Certified Clinical Transplant Nurse (CCTN) Practice Exam

A massive catecholamine storm, which can occur after brain death, leads to significant physiological changes in the body. Specifically, this storm triggers the release of high levels of catecholamines (such as epinephrine and norepinephrine) from the adrenal medulla. These catecholamines typically cause an increase in heart rate, blood pressure, and cardiac output, but in the context of brain death, the body can experience a paradoxical response.

Vasodilation and systemic inflammation arise due to the overwhelming release of these stress hormones. While catecholamines usually promote vasoconstriction and increase blood pressure, the physiological response to brain death causes dysfunction in neurogenic control, leading to extensive vasodilation. This can result in a relative hypovolemia and subsequent hypotension, but the choice emphasizes the systemic inflammatory response rather than just blood pressure changes alone.

This systemic inflammatory response can compromise organ perfusion and contribute to multiple organ dysfunction syndrome, making option B the most relevant choice in the context of the broad-impact changes occurring post-brain death.