title: Ventilator auto-cycling from cardiogenic oscillations: case report and review of literature.
abstract: BACKGROUND
  Brain death is the total loss of all brain and brain stem functions, and its diagnosis is often confirmed by an apnoea test, which relies on disconnecting the patient from the ventilator. Auto-triggering or auto-cycling is defined as a ventilator being triggered in the absence of patient effort, intrinsic respiratory drive or inspiratory muscle activity. Ventilator auto-triggering could delay the diagnosis of brain death leading to unnecessary admission for the patient and false hopes of recovery for the family.
  
  
  METHODS
  We report a case of ventilator auto-triggering associated with cardiogenic oscillations in a female patient.
  
  
  RESULTS
  We confirmed the finding of ventilator auto-triggering by changing the patient's position and reassessing the triggering thresholds. Brain death was then confirmed by apnoea test.
  
  
  CONCLUSIONS
  This case is presented to arouse the awareness of the medical staff and nurses to this phenomenon, which can mimic an intrinsic respiratory effort in patients allegedly diagnosed with brain death. Along with this case report, we review the English language publications for similar cases.
authors: Division of Pulmonary and Critical Care, Department of Medicine, Tannourine Governmental Hospital, Batroun, Lebanon.
authors: Carlos
authors: C
authors: Noujeim
authors: Imad
authors: I
authors: Bouakl
authors: Mohamad
authors: M
authors: El-Khatib
authors: Pierre
authors: P
authors: Bou-Khalil
mesh_terms: D000328:Adult; D001926:Brain Death / Q000175:diagnosis*; D005260:Female; D006801:Humans; D011175:Positive-Pressure Respiration; D015300:Ventilator Weaning; D012122:Ventilators, Mechanical
keywords: Brain death; Cardiogenic oscillations; Ventilator auto-cycling