Prediction of Apnea Testing Duration to Ensure Safety During Brain Death Assessment

Respir Care. 2021 May;66(5):793-797. doi: 10.4187/respcare.08366. Epub 2021 Feb 16.

Abstract

Background: Apnea testing is the last step of brain death assessment. This study aimed to determine whether apnea testing is safer when performed over a shorter duration.

Methods: The medical records of 200 brain-dead donors were retrospectively evaluated. All the records were anonymously registered in the Japanese Ministry of Health, Labor, and Welfare from 1999 to 2012. The rate of [Formula: see text] increase was analyzed to calculate the duration required for apnea testing.

Results: At baseline, body temperature and [Formula: see text] significantly affected the increase rate of [Formula: see text]. At baseline, the apnea testing durations were 4.7 min with normal body temperature and higher [Formula: see text] ([Formula: see text] 40-60 mm Hg, body temperature 36.5°C, [Formula: see text] 400 mm Hg); further, it was 3.0 min with higher body temperature and lower [Formula: see text] at baseline ([Formula: see text] 40-60 mm Hg, body temperature 38.0°C, [Formula: see text] 100 mm Hg).

Conclusions: The specific duration of apnea testing during brain death assessment may be predicted by measuring the increase rate of [Formula: see text].

Keywords: apnea; brain death; diagnostic tests; hypotension; hypoxemia; organ procurement; tissue procurement.

MeSH terms

  • Apnea* / diagnosis
  • Brain Death*
  • Humans
  • Retrospective Studies
  • Temperature
  • Time Factors