Tension pneumothorax complicating apnea testing during brain death evaluation.
Tension pneumothorax is a rare complication of the apnea test using the apneic oxygenation method. In reported cases, it has been attributed to massive air trapping beyond a supplemental oxygen cannula that was obstructing the airway. We report a case of tension pneumothorax, pneumomediastinum, and pneumoperitoneum that developed during the apnea test as a result of direct airway perforation by the supplemental oxygen cannula. We review the literature concerning catastrophic airway complications associated with the apneic oxygenation method and suggest ways to avoid them.
Burns
Joseph D
JD
Department of Neurology, Lahey Clinic Medical Center, Burlington, MA 01805, USA. joseph.burns@lahey.org
Russell
James A
JA
D001049:Apnea / Q000628:therapy; D001926:Brain Death; D018450:Disease Progression; D005260:Female; D006801:Humans; D008478:Mediastinal Emphysema / Q000209:etiology*; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011030:Pneumothorax / Q000209:etiology*