Cardiac Oscillations Complicating Brain Death Diagnosis

Brittany Bolt; Farid Muakkassa; Lindsay Bruening; Cameron Marcus; Brittany Cunningham; Erin Pawlak; Richard Gandee; Christopher Newey

doi:10.1155/2023/1132406

Cardiac Oscillations Complicating Brain Death Diagnosis

Case Rep Crit Care. 2023 Sep 11:2023:1132406. doi: 10.1155/2023/1132406. eCollection 2023.

Authors

Brittany Bolt¹, Farid Muakkassa², Lindsay Bruening³, Cameron Marcus⁴, Brittany Cunningham⁵, Erin Pawlak³, Richard Gandee^{1

3}, Christopher Newey^{1

6}

Affiliations

¹ Cerebrovascular Center, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
² Section of Trauma, Cleveland Clinic Akron General Hospital, Akron, Ohio, USA.
³ Section of Neurology, Cleveland Clinic Akron General Hospital, Akron, Ohio, USA.
⁴ Section of Emergency Medicine, Cleveland Clinic Akron General Hospital, Akron, Ohio, USA.
⁵ Section of Pharmacy, Cleveland Clinic Akron General Hospital, Akron, Ohio, USA.
⁶ Department of Neurocritical Care and ICU-EEG, Sanford Health, Sioux Falls, OH, USA.

Abstract

Death by neurologic criteria (DNC) or brain death is a clinical diagnosis. It is often complicated by variations in policies as well as confounders on examination. We discuss here the case of a 27-year-old male who had a cardiac arrest following toxic gaseous exposure. He ultimately progressed to brain death but was identified as having cardiac oscillations during clinical assessments that complicated the diagnosis. We discuss the case as well as the maneuvers used to clarify that the "triggered breaths" on the ventilator were indeed cardiac oscillations.

Publication types

Case Reports