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August 1991

Apneic Oxygenation in Apnea Tests-Reply

Author Affiliations

Department of Neurology Lincoln Hospital 234 E.149th St Bronx, NY 16451

Arch Neurol. 1991;48(8):789-790. doi:10.1001/archneur.1991.00530200025010

In Reply.  —Dr Keilson asks if our patients were legally alive during the apnea tests. A brain dead patient is biologically dead at the moment of brain failure but is legally alive until brain failure has been confirmed by an apnea test. Our patients were, therefore, legally alive during the apnea tests.Dr Keilson asks if it is permissible to disconnect the ventilator on a patient who is legally alive. Apnea testing, including ventilator disconnect, is required by all currently accepted guidelines for determining brain death.Dr Keilson is not surprised that our nonoxygenated patients became hypoxic and that one patient had cardiac arrest. We share his lack of surprise. Nonetheless, apnea tests are often performed without apneic oxygenation1 and transplantable organs have been lost due to cardiac arrest. We hope that this study encourages all physicians to perform apnea tests with apneic oxygenation.We do not believe that apnea

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