Evidence map›Paper›PMID 38951444›Full record

Observational studyNeurocritical care2024

Prospective Evaluation of a Modified Apnea Test in Brain Death Candidates that Does Not Require Disconnection from the Ventilator.

Johann Lambeck, Jürgen Bardutzky, Christoph Strecker, Wolf-Dirk Niesen

Abstract readObservational Study
In one paragraph

Observational study in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Johann LambeckDepartment of Neurology and Clinical Neurophysiology (Klinik für Neurologie und Neurophysiologie), Freiburg University Medical Center (Universitätsklinikum Freiburg), Breisacherstr. 64, 79106, Freiburg, Germany. johann.lambeck@uniklinik-freiburg.de.ORCID 0000-0002-4078-778X
Jürgen BardutzkyDepartment of Neurology and Clinical Neurophysiology (Klinik für Neurologie und Neurophysiologie), Freiburg University Medical Center (Universitätsklinikum Freiburg), Breisacherstr. 64, 79106, Freiburg, Germany.
Christoph Strecker *Department of Neurology and Clinical Neurophysiology (Klinik für Neurologie und Neurophysiologie), Freiburg University Medical Center (Universitätsklinikum Freiburg), Breisacherstr. 64, 79106, Freiburg, Germany.
Wolf-Dirk Niesen *Department of Neurology and Clinical Neurophysiology (Klinik für Neurologie und Neurophysiologie), Freiburg University Medical Center (Universitätsklinikum Freiburg), Breisacherstr. 64, 79106, Freiburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe apnea test (AT) is an important component in the determination of brain death/death by neurologic criteria (BD/DNC) and often entails disconnecting the patient from the ventilator followed by tracheal oxygen insufflation to ensure adequate oxygenation. To rate the test as positive, most international guidelines state that a lack of spontaneous breathing must be demonstrated when the arterial partial pressure of carbon dioxide (PaCO

methodsThe mAT was performed in all 140 BD/DNC candidates registered between January 2019 and December 2022: after 10 min of preoxygenation, (1) positive end-expiratory pressure was increased by 2 mbar (1.5 mm Hg), (2) ventilation mode was switched to continuous positive airway pressure, and (3) apnea back-up mode was turned off (flow trigger 10 L/min). The mAT was considered positive when spontaneous breathing did not occur upon PaCO

resultsThe mAT was possible in 139/140 patients and had a median duration of 15 min (interquartile range 13-19 min). Severe complications were not evident. In 51 patients, the post-mAT arterial partial pressure of oxygen (PaO

conclusionsThe mAT is a safe and protective means of identifying patients who no longer have an intact central respiratory drive, which is a critical factor in the diagnosis of BD/DNC. Clinical trial registration DRKS, DRKS00017803, retrospectively registered 23.11.2020, https://drks.de/search/de/trial/DRKS00017803.

Indexed as

ApneaBrain DeathAdultAgedFemaleHumansMaleMiddle AgedPositive-Pressure RespirationProspective StudiesApnea testApneic oxygenationBrainstem areflexiaIrreversible loss of brain functionVentilator-based

Identifiers

PMID38951444
PMCPMC11599285

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.