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Apnea testing for the diagnosis of brain death
Author(s) -
Lang C. J. G.,
Heckmann J. G.
Publication year - 2005
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.2005.00527.x
Subject(s) - apnea , medicine , intensive care medicine , hypoventilation , anesthesia , respiratory system
Objectives – A review is given on various methods, preconditions and pitfalls of apnea testing for the diagnosis of brain death. Materials and methods – An extensive medical data base search was implemented by information gathered from books and our own experience with more than 2000 apnea tests. Results – While testing for apnea (AT) is considered indispensable worldwide, recommendations and handling differ. Rather than relying on elapsed time, a specific target value for the partial arterial pressure of carbon dioxide (PaCO 2 ) should be aimed at being the maximum physiological stimulus for respiration. Methodological points are elaborated upon in detail for apneic oxygenation and hypoventilation. Conclusion – AT is an indispensable element of diagnosing brain death. Although with proper handling and adequate precautions AT is safe, it should be performed as a last resort. An international agreement on target values for the PaCO 2 is desirable.