Complications associated with the apnea test in the determination of the brain death.
BACKGROUND
An apnea test is essential in the clinical determination of brain death. This study was conducted to analyse complications associated with the apnea test in the determination of the brain death.


METHODS
On 93 adult patients in coma in Zhejiang Province of China from January 2003 to December 2006, 179 apnea tests were performed as a part of the determination of brain death. Potential risk conditions and complications were analysed during apnea tests.


RESULTS
During apnea, serious cardiac arrhythmia did not occur in all patients. Complications occurred in 37 of 179 (21%) apnea tests. Hypotension occurred in 30 patients (17%) and it was observed in 8/94 (9%) tests with baseline value of systolic arterial blood pressure not less than 120 mmHg, and 22/85 (26%) less than 120 mmHg (P < 0.05). Severe hypoxaemia occurred in 10 patients (6%) of which 3/138 (2%) tests with baseline value of arterial oxygen pressure not less than 200 mmHg, and 7/41 (17%) less than 200 mmHg (P < 0.05).


CONCLUSIONS
This study demonstrated that complications occurred mostly in patients with inadequate baseline systolic arterial blood pressure and preoxygenation. Adequate precautions during the apnea tests may reduce the risk of cardiovascular and oxygenation complication.
Wu
Xiao-liang
XL
Department of Intensive Care Unit, First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Fang
Qiang
Q
Li
Li
L
Qiu
Yun-qing
YQ
Luo
Ben-yan
BY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001049:Apnea / Q000503:physiopathology*; D001926:Brain Death / Q000175:diagnosis*; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D000860:Hypoxia / Q000209:etiology; D008297:Male; D008875:Middle Aged
D002245:Carbon Dioxide