ArticleJournal of intensive care medicine2016
The Modified Apnea Test During Brain Death Determination: An Alternative in Patients With Hypoxia.
Article in Journal of intensive care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- A brain-based definition of death and criteria for its determination after arrest of circulation or neurologic function in Canada: a 2023 clinical practice guideline.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Guideline
- Prospective Evaluation of a Modified Apnea Test in Brain Death Candidates that Does Not Require Disconnection from the Ventilator.Neurocritical care · 2024Observational
- A Recruitment Maneuver After Apnea Testing Improves Oxygenation and Reduces Atelectasis in Organ Donors After Brain Death.Neurocritical care · 2024Article
- Evaluation of the new modified apnea test in confirmation of brain death.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2024Article
- Optimal duration of the apnea test for determining brain death: Benefit of the short-term apnea test.PloS one · 2022Article
- Apnea Testing for the Determination of Brain Death: A Systematic Scoping Review.Neurocritical care · 2021Article
- Special considerations in the assessment of catastrophic brain injury and determination of brain death in patients with SARS-CoV-2.Journal of the neurological sciences · 2020Article
- Use of CPAP as an alternative to the apnea test during the determination of brain death in hypoxemic patients. Report of two cases.Revista Brasileira de terapia intensiva · 2020Article
- Comparison of Two Apnea Test Methods, Oxygen Insufflation and Continuous Positive Airway Pressure During Diagnosis of Brain Death: Final Report.Neurocritical care · 2019Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
introductionConventional apnea testing in patients with severe hypoxemia or hemodynamic instability with removal from the ventilator support is unsafe. We describe an alternative approach to apnea testing, which may be used in patients with hypoxia unable to undergo conventional apnea testing.
methodsCase Report. A 42-year-old man had a severe traumatic brain injury resulting in diffuse cerebral edema and subarachnoid hemorrhage with herniation. His presentation was complicated by hypoxic respiratory failure from pulmonary contusions and hemorrhagic shock. On hospital day 2, the patient lost brain stem reflexes. Brain death testing with conventional apnea testing was attempted but aborted due to hypoxia.
resultsA modified apnea test was applied, which had been approved by appropriate hospital committees including critical care operations, ethics, and the brain death protocol council. Minute ventilation was gradually decreased by ≥50% to attain a PaCo2 level ≥20 mm Hg above baseline. The ventilation mode was then switched from volume control to continuous positive airway pressure while observing the patient for signs of respiration for a duration of 60 seconds.
conclusionThe modified apnea test does not require circuit disconnection and can be successfully applied to determine brain death without compromising safety in high-risk patients having severe hypoxia.
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Registered trials
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