Apnea Tests as the Methods of Brain Death Diagnosis.
Keywords
Abstract
Description
Apnea test (AT) is one of the most important examination during the diagnosis of brain death. It is usually performed at the end of each series of clinical examinations during diagnostic process. The most popular standard insufflation apnea test (I-AT) may be potentially harmful. It may cause some serious complications including pneumothorax, severe hypoxemia, hemodynamic instability and even cardiac arrest. Therefore, the investigators decided to analyze apnea test in CPAP option (CPAP-AT) as a new tool. For safety of the study the investigators analyzed a method after BD diagnosis.
Methods:
I-AT and hypoventilation with 100 % oxygen (if needed) were performed according to Polish guidelines. Two hours after BD diagnosis was performed extra apnea test in CPAP option (CPAP-AT). Before CPAP-AT the patients were ventilated 100% oxygen. After then the ventilator settings were changed to CPAP mode with PEEP 10 cm H2O, PS 0 cm H2O, FiO2 1,0, flow 6L/min. Emergency apnea ventilation was turned off. At the beginning of CPAP mode and 10 minutes after, blood samples for arterial blood gases (ABG) were collected. If were observed rapid desaturation defined as a decline in O2 saturation below 85%, CPAP-AT was aborted and study was finished.
During routine diagnosis of brain death, pupillary dilation after a neck flexion was observed in one case. Therefore, the investigators decided to use a pupillometer during brain death examination to find out how pupils react after a neck flexion and how often it happens.
Pupil measurements were taken immediately after the diagnosis of brain death. The measurements of pupil diameter were taken twice: A - before neck flexion; B - after neck flexion. We used pupillometer: AlgiScan (Equip Medkey BV).
Dates
| Last Verified: | 08/31/2017 |
| First Submitted: | 09/02/2017 |
| Estimated Enrollment Submitted: | 09/10/2017 |
| First Posted: | 09/12/2017 |
| Last Update Submitted: | 09/12/2017 |
| Last Update Posted: | 09/13/2017 |
| Actual Study Start Date: | 06/24/2015 |
| Estimated Primary Completion Date: | 06/24/2015 |
| Estimated Study Completion Date: | 06/24/2017 |
Condition or disease
Intervention/treatment
Other: CPAP-AT
Phase
Arm Groups
| Arm | Intervention/treatment |
|---|---|
| CPAP-AT After 2 hours from I-AT was performed the alternative AT by CPAP ventilation mode. Before CPAP-AT and 10 minutes after blood samples for arterial blood gases (ABG) were collected. If the investigators observe rapid desaturation defined as a decline in O2 saturation below 85%, CPAP-AT was aborterd. | Other: CPAP-AT If the investigators observe rapid desaturation defined as a decline in O2 saturation below 85%; the CPAP apnea test (CPAP-AT) test was aborted. |
Eligibility Criteria
| Ages Eligible for Study | 18 Years To 18 Years |
| Sexes Eligible for Study | All |
| Sampling method | Non-Probability Sample |
| Accepts Healthy Volunteers | Yes |
| Criteria | Inclusion Criteria: - brain death diagnosis Exclusion Criteria: - no |
Outcome
Primary Outcome Measures
1. Change from baseline arterial blood gases (ABG) during CPAP-AT [10 minutes]
