当前位置： SCI文献检索 > EUROPEAN JOURNAL OF ANAESTHESIOLOGY期刊下所有文献 > An evaluation of capnography monitoring during the apnoea test in brain-dead patients.

An evaluation of capnography monitoring during the apnoea test in brain-dead patients.

Abstract：

BACKGROUND AND OBJECTIVE:Diagnosis of brain death usually requires the absence of spontaneous respiratory movements during the apnoea test and an arterial carbon dioxide partial pressure above 60 mmHg. On the other hand, although capnography (end-tidal CO(2)) is currently monitored in intensive care unit patients, it has not been evaluated during the apnoea test in brain-dead patients. Therefore, the aim of this prospective study was first to investigate the usefulness of capnography monitoring, and secondly to evaluate the variation of the carbon dioxide partial pressure-end-tidal CO(2) gradient during the apnoea test in clinically brain-dead patients. METHODS:After local Ethics Committee approval, 60 clinically brain-dead patients were investigated. End-tidal CO(2) was continuously recorded before, during and after the apnoea test. Arterial blood gases were sampled immediately before and after the apnoea test for calculation of the carbon dioxide partial pressure-end-tidal CO(2) gradient. RESULTS:The apnoea test was clinically positive in 58 patients, whereas end-tidal CO(2) was equal to 0 during the apnoea. During the 20-min apnoea test, carbon dioxide partial pressure increased from 40 +/- 7 to 97 +/- 19 mmHg (P < 0.001) with a rate of 2.8 +/- 0.9 mmHg min(-1), end-tidal CO(2) increased from 31 +/- 6 to 68 +/- 17 mmHg (P < 0.001) and carbon dioxide partial pressure-end-tidal CO(2) gradient increased from 9 +/- 4 to 29 +/- 10 mmHg (P < 0.001). In two patients, the apnoea test was clinically negative because of the occurrence of spontaneous respiratory movements, whereas capnography showed contemporaneously significant increases in end-tidal CO(2). CONCLUSIONS:End-tidal CO(2) should be systematically monitored and recorded, at least for medico-legal considerations, during the apnoea test in brain-dead patients. The high variability in the carbon dioxide partial pressure-end-tidal CO(2) gradient increase precludes any extrapolation of the carbon dioxide partial pressure from the end-tidal CO(2) at the end of the apnoea test.

journal_name

Eur J Anaesthesiol

journal_title

European journal of anaesthesiology

authors

Vivien B,Amour J,Nicolas-Robin A,Vesque M,Langeron O,Coriat P,Riou B

doi

10.1017/S0265021507000725

subject

Has Abstract

pub_date

2007-10-01 00:00:00

pages

868-75

issue

eissn

0265-0215

issn

1365-2346

pii

S0265021507000725

journal_volume

pub_type

临床试验,杂志文章

在线工具

An evaluation of capnography monitoring during the apnoea test in brain-dead patients.