Apnea testing, a simple prognostic test for diagnosis of brain death

Abstract

Introduction: Brain-death is the end stage of most illnesses that cause brain injury and decrease oxygenation and circulation of brain tissues. Early determination of brain-death isessential to the prevention of expensive modeling in the pediatric intensive care unit (PICU)and reserving facilities for patients with good prognosis. Apnea test is one of the importantbrain-death determining methods in clinical evaluation that can be performed easier and fasterthan other methods. Methods: In a cross-sectional study, 75 patients with brain-death criteria were evaluated from2003-2011. Apnea testing was fulfilled through standard methods. Patients who did not develop spontaneous respiration at PaCo level of 60 mmHg or more were confirmed as brain-dead. Results: Mean age of patients was 40 months. All patients were comatose, without brainstemreflexes. Cause of coma was status epilepticus in most patients. All patients that had a positive apnea test died after a mean duration of 8 days.Conclusion: All other confirmative methods, irrespective of their accuracy, need complexinstruments and experienced manpower, and are expensive which makes their preparation impossible in most ICU centers. However, apnea test is a simple prognostic method in braindeathconfirmationwith100%accuracy.​

Keywords

• Apnea testing
• Brain death
• Pediatrics