[Barotrauma by Venturi effect during apnea testing for the determination of brain death. Should it change the terms of application of this test?].
The clinical diagnosis of brain death is based on three clinical criteria, one of them being the abolition of the spontaneous breathing shown by an apnoea testing [1,2]. During this manoeuvre, oxygen is administered by intratracheal way through oxygen supply tubing inserted into the endotracheal tube. Few cases of barotrauma with tension pneumothorax during this test have been described in the literature bringing to the loss of potential donor or grafts for transplantation. The authors report a new case of tension pneumothorax occurred during an apnoea testing despite the precautionary measures necessary to prevent such a catastrophic complication. In addition to the possible pathophysiologic explanation of the event advanced by the authors, it seems lawful to redefine the practical modalities of implementation of this test to avoid the loss of potential grafts.
Cros
J
J
Département d'anesthésie-réanimation, CHU Dupuytren, 2 avenue Martin-Luther-King, Limoges, France.
Pichon
N
N
Dugard
A
A
Vignon
P
P
François
B
B
D001469:Barotrauma / Q000209:etiology*; D001926:Brain Death / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology; D012129:Respiratory Function Tests / Q000009:adverse effects