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apnea test

Indications: - determination of brain death in a patient with clinical findings* consistent with brain death * coma; absence of motor response, pupillary response, corneal reflex, jaw jerk, gag reflex, oculovestibular reflex, reaction to craniofacial pain, cough with tracheal suctioning, sucking reflex Procedure: - initiated when the arterial pCO2 is between 40-60 mm Hg, the patient is normothermic, & has received no sedative - the patient is disconnected from the ventilator to obtain a baseline pCO2 value - during this time, the patient may receive supplemental oxygen - arterial blood gas measurements are repeated at 1 minute, 5 minutes & up to 8 minutes while spontaneous respirations are observed - the apnea test is positive if the pCO2 increases by > 20 mm Hg in the absence of respirations Clinical significance: - a positive test confirms brain death - no further testing is indicated

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apnea brain death

General

clinical procedure

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012