Risk of hypotension during apnea testing.
OBJECTIVE
To determine the safety of apnea testing.


METHODS
Prospective, consecutive study.


METHODS
Inner-city trauma center.


METHODS
A total of 70 apnea tests were performed on 61 comatose patients as part of the determination of brain death.


RESULTS
Only 43 examinations (61%) were well tolerated. During 27 examinations (39%) patients either developed marked hypotension (> or = 15% drop in mean arterial pressure) (n = 23) or required prophylactic vasopressor manipulation (n = 4). Of the 27 examinations in which hypotension developed, 14 were aborted, two were tolerated despite marked hypotension, four were tolerated after administration of prophylactic epinephrine (n = 1) or dopamine hydrochloride (n = 3), and seven were successfully completed after increases in the rate of dopamine infusion during the test.


CONCLUSIONS
Hypotension can pose a significant risk to patients undergoing apnea testing. Constant monitoring of vital signs throughout the test is essential to its safe completion.
Jeret
J S
JS
Department of Neurology, State University of New York Health Science Center at Brooklyn.
Benjamin
J L
JL
D000328:Adult; D001049:Apnea; D001926:Brain Death / Q000175:diagnosis; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D008722:Methods; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000627:therapeutic use*; D011446:Prospective Studies
D010100:Oxygen