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Brain death diagnosis and apnea test safety. | LitMetric

Brain death diagnosis and apnea test safety.

Ann Indian Acad Neurol

Institute of Neurology and Neurosurgery, Department of Clinical Neurophysiology, Havana, Cuba.

Published: July 2009

AI Article Synopsis

  • - The apnea test is a crucial procedure for diagnosing brain death, as it indicates the loss of brainstem function, but it comes with potential safety risks including severe hypotension and cardiac issues.
  • - Concerns about complications can lead to test cancellations, which may affect the diagnosis of brain death; however, using proper oxygen procedures is key to ensuring the test's safety.
  • - Despite potential risks, the apnea test remains essential, and if it cannot be performed or is stopped, alternative tests should be utilized to confirm brain death.

Article Abstract

The apnea test is a mandatory examination for determining brain death (BD), because it provides an essential sign of definitive loss of brainstem function. However, several authors have expressed their concern about the safety of this procedure as there are potential complications such as severe hypotension, pneumothorax, excessive hypercarbia, hypoxia, acidosis, and cardiac arrhythmia or asystole. These complications may constrain the examiner to abort the test, thereby compromising BD diagnosis. Nevertheless, when an appropriate oxygen-diffusion procedure is used, this technique is safe. We review here the prerequisites to begin the test, its procedure, potential complications, and the use of alternative ancillary tests. We recommend that the apnea test be retained as a mandatory procedure for the diagnosis of BD. In those situations when the apnea test is terminated by the examiner for some reason or when it is impossible to carry it out in a patient due to the presence of some pathologic condition, alternative ancillary tests should be used to confirm BD.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824942PMC
http://dx.doi.org/10.4103/0972-2327.56326DOI Listing

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