Comparison of Two Apnea Test Methods, Oxygen Insufflation and Continuous Positive Airway Pressure During Diagnosis of Brain Death: Final Report

Introduction Deterioration of the pulmonary function after the apnea test (AT) conducted with the classic oxygen insufflation AT (I-AT) is often observed during the brain death (BD) diagnosis procedure. In the present study, two AT methods were compared before a method is recommended for the current...

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Bibliographic Details
Published in:Neurocritical care 2019-04, Vol.30 (2), p.348-354
Main Authors: Solek-Pastuszka, Joanna, Biernawska, Jowita, Iwańczuk, Waldemar, Kojder, Klaudyna, Chelstowski, Kornel, Bohatyrewicz, Romuald, Sawicki, Marcin
Format: Article
Language:English
Subjects:
Adult
Aged
Apnea - diagnosis
Blood pressure
Brain death
Brain Death - diagnosis
Brain Diseases
Catheters
Continuous positive airway pressure
Continuous Positive Airway Pressure - adverse effects
Continuous Positive Airway Pressure - standards
Critical Care - standards
Critical Care Medicine
Female
Humans
Hypoventilation
Insufflation - standards
Intensive
Intensive care
Internal Medicine
Intubation
Male
Medical diagnosis
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Neurology
Original
Original Article
Oxygen
Patients
Pneumothorax
Poland
Practice Guidelines as Topic - standards
Ventilators
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Summary:Introduction Deterioration of the pulmonary function after the apnea test (AT) conducted with the classic oxygen insufflation AT (I-AT) is often observed during the brain death (BD) diagnosis procedure. In the present study, two AT methods were compared before a method is recommended for the currently revised Polish BD criteria. Methods Classic I-AT and continuous positive airway pressure AT (CPAP-AT) were performed in 60 intensive care unit patients. I-AT was performed at the end of two series of clinical tests, and approximately 1–1.5 h later, after BD was confirmed, a different method, CPAP-AT with 100% FiO 2 and CPAP value of 10 cm H 2 O provided by a ventilator in CPAP mode was performed. The patients in I-AT and CPAP-AT groups were further divided into two subgroups: non-hypoxemic (NH) with good lung function before AT (PaO 2 /FiO 2 index ≥ 200 mmHg) and hypoxemic (H) with poor lung function (PaO 2 /FiO 2 index 
ISSN:1541-6933
1556-0961
DOI:10.1007/s12028-018-0608-7