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December 1986

Apnea Testing in Brain Death

Author Affiliations

From the Department of Neurology (Dr Belsh) and the Department of Medicine, Division of Pulmonary and Critical Care Medicine (Dr Schiffman), University of Medicine and Dentistry of New Jersey (UMDNJ)—Robert Wood Johnson Medical School, New Brunswick; and the Neurology Service (Dr Belsh) and the Departments of Respiratory Therapy Services (Ms Blatt) and Medicine (Dr Schiffman), Robert Wood Johnson University Hospital, New Brunswick, NJ.

Arch Intern Med. 1986;146(12):2385-2388. doi:10.1001/archinte.1986.00360240117020

• A standardized protocol was followed in 33 apneic oxygenation tests on 20 patients suspected of being brain dead. Spontaneous respiratory movements developed in just one patient; this patient was the only one who did not show electrocerebral silence on electroencephalography. Significant hypoxemia, hypotension, or cardiac arrhythmias were not encountered despite lung disease in 14 of our 20 patients. The apnea test protocol employed proved to be safe and sensitive. With a starting partial arterial carbon dioxide pressure greater than or equal to 36 mm Hg and a disconnection time from the ventilator of ten minutes in a normothermic patient (≥36.1°C [≥97°F]), the pressure threshold of 60 mm Hg should be reached in all patients.

(Arch Intern Med 1986;146:2385-2388)

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