Abstract:
INTRODUCTION:The apnea test is a crucial component of the clinical diagnosis of brain death. Apprehension about hypoxemia, hypotension, and/or cardiac arrhythmias may sometimes lead clinicians to avoid performing or prematurely terminate the apnea test. The purpose of this study was to perform a contemporary re-evaluation of the safety of the apnea test. METHODS:We performed a detailed chart review of consecutive brain dead patients who underwent an apnea test from 2008 to 2012. RESULTS:Out of 63 patients, 33 were men (52.4 %). Mean age was 46.4 years. In all but four patients (93.7 %), the apnea test was performed by a neurointensivist. Infiltrates on chest radiographs were present in 34 (54 %). Seven patients (11.1 %) had chest tubes, six of which were associated with polytrauma. Echocardiograms were obtained in 47 patients (74.6 %), and 18 patients (38.3 %) had regional wall motion abnormalities (IQR 41-65 %). Fifty patients (79.4 %) were on vasopressors prior to apnea test. Median FiO2 was 0.5 (IQR 0.4-0.6), and PEEP was 5 cm H2O (IQR 5-10). After apnea test, median pO2 was 306 mmHg (IQR 121-389). Apnea test was aborted in only one patient; this patient had required FiO2 0.9-1.0 prior to the test and desaturated during the test. Mild hypoxemia occurred in three others without any consequences. Mild hypotension occurred in 11 patients (17.4 %) and was easily managed by an increase in the vasopressor infusion. There were no instances of major cardiac arrhythmias. CONCLUSION:Apnea determined using the oxygenation diffusion method during brain death testing is very safe, provided appropriate prerequisites are met. We found a major decrease in the number of aborted or not attempted apnea tests compared to previous studies.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Datar S,Fugate J,Rabinstein A,Couillard P,Wijdicks EFdoi
10.1007/s12028-014-9958-ysubject
Has Abstractpub_date
2014-12-01 00:00:00pages
392-6issue
3eissn
1541-6933issn
1556-0961journal_volume
21pub_type
杂志文章abstract:BACKGROUND:Burst suppression in mechanically ventilated intensive care unit (ICU) patients is associated with increased mortality. However, the relative contributions of propofol use and critical illness itself to burst suppression; of burst suppression, propofol, and critical illness to mortality; and whether preventi...
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01140-w
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journal_title:Neurocritical care
pub_type: 杂志文章
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journal_title:Neurocritical care
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-010-9358-x
更新日期:2010-08-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9389-3
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abstract:: ...
journal_title:Neurocritical care
pub_type: 杂志文章
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更新日期:2019-04-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-011-9568-x
更新日期:2012-02-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1007/s12028-015-0236-4
更新日期:2016-04-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2007-01-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
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更新日期:2014-10-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
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更新日期:2020-04-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
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更新日期:2014-12-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
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更新日期:2009-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-08-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2012-10-01 00:00:00
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pub_type: 临床试验,杂志文章
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