We thank Wijdicks for finding our study1 "very well done" and containing "important data," but it is not "more important than the authors realized themselves." The legal implications, eg, need for informed consent, are being explored (C. D. Zwiebel, Esq, oral communication). The moral implications of performing a potentially dangerous diagnostic test with no therapeutic implications for the patient2 are also being addressed (Abraham S. Abraham, MD, written communications, January, 21, 1990, and October 21, 1991, and J. David Bleich, PhD, a rabbi, written communication, December 24, 1992). The State University of New York institutional apnea testing protocol has also been modified. The medical implications and dire need to meticulously monitor patients during apnea testing are apparent from our study.We undertook our study because although the fact that "hypotension develops during apnea testing... is well recognized, " formal studies other than anecdotal reports were conspicuously lacking.
Jeret JS, Benjamin J. In Search of a Safe Apnea Test in Brain Death: Is the Procedure Really More Dangerous Than We Think?-Reply. Arch Neurol. 1995;52(4):338–339. doi:10.1001/archneur.1995.00540280018006
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