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December 1991

Apnea Tests for Brain Death

Author Affiliations

The Chaim Sheba Medical Center Sackler School of Medicine Tel-Hashomer, 52621 Israel

Arch Neurol. 1991;48(12):1215-1216. doi:10.1001/archneur.1991.00530240017007

To the Editor.  —In the October 1990 issue of the Archives, Marks and Zisfein1 have reported a prospective controlled study of apneic oxygenation in 15 patients who underwent apnea tests for brain death. Their results showed that the patients given room air during the test became hypoxic, while those given continuous apneic oxygenation by tracheal cannula had little or no hypoxia at the end of the test. The authors commented that, to their knowledge, their report is the first prospective controlled study of apneic oxygenation and concluded that preoxygenation alone does not prevent hypoxia during apnea tests for brain death.Other authors2,3 have previously recommended the use of oxygen supplementation by a catheter via the endotracheal tube. However, both studies included one patient, each of whom developed either extreme hypoxemia2 or pulmonary edema and cardiac arrest3 during the apnea test. Indeed, many patients with head trauma

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